Howard Yu-Hao Liu1, Robin Milne2, Gregory Lock3, Benedict James Panizza4, Anne Bernard5, Matthew Foote6, Margaret McGrath6, Elizabeth Brown6, Mitesh Gandhi3, Sandro Virgilio Porceddu7. 1. Department of Cancer Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, St. Lucia, Australia. Electronic address: howard.liu@health.qld.gov.au. 2. Faculty of Medicine, University of Queensland, St. Lucia, Australia. 3. Department of Medical Imaging, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Queensland, Australia. 4. Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Queensland, Australia. 5. QFAB Bioinformatics, Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia. 6. Department of Cancer Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Queensland, Australia. 7. Department of Cancer Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, St. Lucia, Australia.
Abstract
OBJECTIVES: To assess the utility of a repeat positron emission tomography/computed tomography (PET/CT) instead of immediate neck dissection (ND) for incomplete nodal response (IR) in Human Papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPC) following chemoradiotherapy/radiotherapy [(chemo)RT]. MATERIALS AND METHODS: Patients with non-distant metastatic, node positive (N+) disease treated between Jan/2005 to Jan/2016, achieved complete response at the primary with no distant relapse on a 12-week re-staging PET/CT were evaluated. Patients underwent surveillance after complete nodal response (CR). Patients with IR underwent repeat PET/CT at 16 weeks to direct neck management. Primary endpoints were CR conversion rate and subsequent regional failure following a 16-week PET/CT directed ND. Secondary endpoints were predictive values (PV) of the 12- and 16-week PET/CT for residual nodal disease, predictors for requiring the 16-week PET/CT, 5 year regional, locoregional failure free survival (FFS) and overall survival (OS). RESULTS: 235 patients were evaluated. Median follow up was 56 (range 19-60) months. 41 patients underwent 16-week re-staging PET/CT, 29 (71%) converted to CR. No subsequent regional failures occurred following a 16-week PET/CT directed ND. Positive and negative PV of the 12- and 16-week PET/CT for residual nodal disease was 12% & 98%, and 33% & 97%, respectively. N-category (AJCC/UICC 7th edition) predicted for requiring a 16-week PET/CT on univariate analysis (P-value 0.02). 5 year regional, locoregional FFS and OS was 95.8%, 93.4% and 90.8%, respectively. CONCLUSION: For N+ HPV-associated OPC achieving IR on the 12-week re-staging PET/CT following (chemo)RT, a repeat 16-week PET/CT can spare patients from unnecessary surgery.
OBJECTIVES: To assess the utility of a repeat positron emission tomography/computed tomography (PET/CT) instead of immediate neck dissection (ND) for incomplete nodal response (IR) in Human Papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPC) following chemoradiotherapy/radiotherapy [(chemo)RT]. MATERIALS AND METHODS:Patients with non-distant metastatic, node positive (N+) disease treated between Jan/2005 to Jan/2016, achieved complete response at the primary with no distant relapse on a 12-week re-staging PET/CT were evaluated. Patients underwent surveillance after complete nodal response (CR). Patients with IR underwent repeat PET/CT at 16 weeks to direct neck management. Primary endpoints were CR conversion rate and subsequent regional failure following a 16-week PET/CT directed ND. Secondary endpoints were predictive values (PV) of the 12- and 16-week PET/CT for residual nodal disease, predictors for requiring the 16-week PET/CT, 5 year regional, locoregional failure free survival (FFS) and overall survival (OS). RESULTS: 235 patients were evaluated. Median follow up was 56 (range 19-60) months. 41 patients underwent 16-week re-staging PET/CT, 29 (71%) converted to CR. No subsequent regional failures occurred following a 16-week PET/CT directed ND. Positive and negative PV of the 12- and 16-week PET/CT for residual nodal disease was 12% & 98%, and 33% & 97%, respectively. N-category (AJCC/UICC 7th edition) predicted for requiring a 16-week PET/CT on univariate analysis (P-value 0.02). 5 year regional, locoregional FFS and OS was 95.8%, 93.4% and 90.8%, respectively. CONCLUSION: For N+ HPV-associated OPC achieving IR on the 12-week re-staging PET/CT following (chemo)RT, a repeat 16-week PET/CT can spare patients from unnecessary surgery.
Keywords:
Chemotherapy; Head and neck cancer; Human papillomavirus; Neck dissection; Oropharyngeal cancer; PET surveillance; PET/CT; Radiotherapy; Response assessment; Restaging
Authors: Robin J D Prestwich; Moses Arunsingh; Jim Zhong; Karen E Dyker; Sriram Vaidyanathan; Andrew F Scarsbrook Journal: Eur Radiol Date: 2019-08-29 Impact factor: 5.315
Authors: Travis C Salzillo; Nicolette Taku; Kareem A Wahid; Brigid A McDonald; Jarey Wang; Lisanne V van Dijk; Jillian M Rigert; Abdallah S R Mohamed; Jihong Wang; Stephen Y Lai; Clifton D Fuller Journal: Semin Radiat Oncol Date: 2021-10 Impact factor: 5.421
Authors: Olgun Elicin; Paul Martin Putora; Marco Siano; Martina A Broglie; Christian Simon; Daniel Zwahlen; Gerhard F Huber; Giorgio Ballerini; Lorenza Beffa; Roland Giger; Sacha Rothschild; Sandro V Negri; Pavel Dulguerov; Guido Henke Journal: Front Oncol Date: 2019-10-24 Impact factor: 6.244
Authors: David Landin; Anders Näsman; Sara Jonmarker Jara; Lalle Hammarstedt-Nordenvall; Eva Munck-Wikland; Tina Dalianis; Linda Marklund Journal: Viruses Date: 2022-07-30 Impact factor: 5.818
Authors: Zsuzsanna Iyizoba-Ebozue; Sarah Billingsley; Russell Frood; Sriram Vaidyanathan; Andrew Scarsbrook; Robin J D Prestwich Journal: Cancers (Basel) Date: 2022-09-26 Impact factor: 6.575
Authors: S Connor; C Sit; M Anjari; M Lei; T Guerrero-Urbano; T Szyszko; G Cook; P Bassett; V Goh Journal: J Cancer Res Clin Oncol Date: 2021-06-22 Impact factor: 4.553
Authors: G C Mayne; C M Woods; N Dharmawardana; T Wang; S Krishnan; J C Hodge; A Foreman; S Boase; A S Carney; E A W Sigston; D I Watson; E H Ooi; D J Hussey Journal: J Transl Med Date: 2020-07-10 Impact factor: 5.531
Authors: Saskia H Hanemaaijer; Maran Fazzi; Roel J H M Steenbakkers; Bart Dorgelo; Bert van der Vegt; Max J H Witjes; Bernard F A M van der Laan; Sjoukje F Oosting; Gilles N Stormezand; Boudewijn E C Plaat Journal: Clin Otolaryngol Date: 2020-05-25 Impact factor: 2.597