BACKGROUND: No risk-stratification strategies exist for patients with recurrent oropharyngeal cancer (OPC).
METHODS: Retrospective analysis using data from prospective NRG Oncology clinical trials RTOG 0129 and 0522. Eligibility criteria included known p16 status and smoking history, and locoregional/distant recurrence. Overall survival (OS) was measured from date of recurrence. Recursive partitioning analysis was performed to produce mutually exclusive risk groups.
RESULTS: Hundred and fifty-four patients were included with median follow-up after recurrence of 3.9 years (range 0.04-9.0). The most important factors influencing survival were p16 status and type of recurrence, followed by surgical salvage and smoking history (≤20 vs. >20 pack-years). Three significantly different risk groups were identified. Patients in the low-, intermediate-, and high-risk groups had 2-year OS after recurrence of 81.1% (95%CI 68.5-93.7), 50.2% (95%CI 36.0-64.5), and 20.8% (95%CI 10.5-31.1), respectively.
CONCLUSION: Patient and tumor characteristics may be used to stratify patients into risk groups at the time of OPC recurrence.
Bigelow, E. O., Harris, J., Fakhry, C., Gillison, M. L., Nguyen-Tân, P. F., Rosenthal, D. I., Frank, S. J., Nair, S. G., Bahig, H., Ridge, J. A., Caudell, J., Donaldson, C., Clifford, B. T., Shenouda, G., Birrer, M. J., Chen, Y., & Le, Q. T. (2022). Risk stratification after recurrence of human papillomavirus (HPV)-related and non-HPV-related oropharyngeal cancer: Secondary analysis of NRG Oncology RTOG 0129 and 0522. Head & neck, 44(1), 158–167. https://doi.org/10.1002/hed.26915