title: Positron emission tomography/computed tomography after primary transoral robotic surgery for oropharyngeal squamous cell carcinoma.
abstract: To assess the first post-treatment positron emission tomography/computed tomography (PET/CT) in prediction of disease-free survival after primary transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) with or without adjuvant chemoradiation.
  
  
  
  Retrospective review.
  
  
  
  Ninety-five patients with OPSCC treated with primary TORS from 2010 to 2014 at a single tertiary academic center were evaluated with PET/CT. Imaging was performed between 2 and 7 months after completing all treatment. Radiology findings were categorized as 1) negative, noting either complete resolution of foci without evidence of disease or anatomical changes likely attributed to treatment; 2) equivocal, noting equal likelihood of malignancy versus treatment-related changes; or 3) positive, noting either findings concerning for malignancy or new hyperactivity not attributed to treatment-related changes. The median follow-up time was 31 months (range, 23-63 months). Recurrence was defined as biopsy-proven invasive malignancy or clinical suspicion sufficient to initiate treatment occurring within 3 years of the completion of all treatment.
  
  
  
  Of 95 total patients with at least 2 years of follow-up records, 26 had positive post-treatment PET/CT results, with five experiencing actual recurrences. Of 69 patients with negative post-treatment PET/CT results, none experienced recurrences. These results indicate a sensitivity of 100%, specificity of 77%, positive predictive value of 19%, and negative predictive value of 100%.
  
  
  
  A majority of TORS patients (73%) will have a negative first post-treatment PET/CT. A single negative post-treatment PET/CT is strongly correlated with 2-year disease-free survival in patients treated with primary TORS and may warrant decreased surveillance imaging.
  
  
  
  4 Laryngoscope, 127:2050-2056, 2017.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Kealan
authors.initials: K
authors.lastname: Hobelmann
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Adam
authors.initials: A
authors.lastname: Luginbuhl
authors.affiliation: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Voichita
authors.initials: V
authors.lastname: Bar-Ad
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
authors.forename: William
authors.initials: W
authors.lastname: Keane
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
authors.forename: Joseph
authors.initials: J
authors.lastname: Curry
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
authors.forename: David
authors.initials: D
authors.lastname: Cognetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods / Q000706:statistics & numerical data*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: Oropharynx; PET imaging; TORS; radiology; robotic surgery