Posttreatment surveillance PET/CT for HPV-associated oropharyngeal cancer.

Autor: Corpman DW; Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California.; University of California, San Francisco School of Medicine, San Francisco, California., Masroor F; Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California., Carpenter DM; Division of Research, Kaiser Permanente Northern California, Oakland, California., Nayak S; Department of Radiology, Kaiser Permanente San Leandro Medical Center, San Leandro, California., Gurushanthaiah D; Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California., Wang KH; Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2019 Feb; Vol. 41 (2), pp. 456-462. Date of Electronic Publication: 2018 Dec 14.
DOI: 10.1002/hed.25425
Abstrakt: Background: Surveillance positron emission tomography-computed tomography (PET/CT) is commonly used for treatment assessment of radiation therapy in head and neck cancer. However, human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV+OPSCC) patients represent a unique subpopulation, for which the utility of surveillance PET/CT has not been well studied.
Methods: In this retrospective chart review comprising 233 HPV+OPSCC patients, we evaluated surveillance PET/CT for diagnostic accuracy, downstream clinical impact, and survival.
Results: Surveillance PET/CT demonstrated 100% negative predictive value and sensitivity, 59.9% specificity, and 13.4% positive predictive value. Surveillance PET/CT led to 90 imaging studies and 31 biopsies; 91.1% and 77.4% were negative for recurrence, respectively. Surveillance PET/CT led to meaningful salvage therapy in 1.6% of cases. PET/CT-detected recurrences did not have improved survival compared to clinically detected recurrences.
Conclusion: For HPV+OPSCC patients, surveillance PET/CTs frequently lead to unnecessary testing and rarely to meaningful disease salvage. They have no demonstrated survival benefit and should be interpreted cautiously to prevent patient harm.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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