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Background. The optimal treatment for patients with recur- rent human papillomavirus (HPV)-positive head and neck cancer is poorly understood. Methods. We investigated treatments and outcomes in patients with recurrent head and neck cancer. Treatments included salvage neck sur- gery, metastasectomy, hypofractionated reirradiation, chemoemboliza- tion, and chemotherapy. Treatment outcomes were compared based on HPV status. Results. A total of 37 patients were identified (12 HPV positive and 25 HPV negative). Demographics were similar. Overall, there was a trend toward a higher number of total treatment interventions in patients with HPV-positive disease (4.5 vs 2.6), but this was statistically insignificant (p 5.066). After a mean follow-up of 21 months, median survival in HPV-negative patients was 10.6 months, whereas the median survival had not been reached for HPV-positive patients. Of the 12 HPV-positive patients, 7 were still alive (58%) after a mean follow-up period of 33 months. Conclusion. Multimodality aggressive therapy may improve overall sur- vival in patients with recurrent HPV-positive disease. Further prospective research is warranted. V C 2014 Wiley Periodicals, Inc. Head Neck 00: 000-000, 2014 |
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