Predictive accuracy of first post-treatment PET/CT in HPV-related oropharyngeal squamous cell carcinoma

Laryngoscope. 2014 Aug;124(8):1843-7. doi: 10.1002/lary.24617. Epub 2014 Mar 11.


Objectives/hypothesis: To determine whether the result of first posttreatment positron emission tomography and computed tomography (PET/CT) is predictive of outcome in patients with oropharyngeal squamous cell carcinoma (OPSCC), and whether PET/CT accuracy is affected by human papillomavirus (HPV) status.

Study design: Retrospective review.

Methods: Demographic, clinical, and radiographic data were available for 61 patients with OPSCC, treated in 2004 to 2012 at a single tertiary academic referral center, with at least one baseline and one posttreatment PET/CT. Clinical follow-up was obtained every 3 months thereafter. The median follow-up time was 36 months (range 3-100 months).

Results: Of 61 patients, 48 (79%) had negative first posttreatment PET/CT results; and overall, 18 of the 61 patients (30%) recurred. All accuracy measures for PET/CT were higher in HPV-positive patients, including a 93% negative predictive value (NPV). Patients with positive PET/CT results had poorer survival on Kaplan-Meier analyses. On multivariate analysis of factors predictive of recurrence, two parameters were significant: HPV status (P = 0.0046) and PET/CT result (P <0.0001).

Conclusions: A negative first posttreatment PET/CT result is associated with better prognosis and rare recurrence, especially in patients with HPV-positive status. Less frequent radiologic surveillance is warranted in patients with HPV-positive OPSCC and a negative first posttreatment PET/CT scan.

Keywords: PET/CT; head and neck squamous cell carcinoma (HNSCC); human papillomavirus; oropharynx; surveillance.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / therapy*
  • Carcinoma, Squamous Cell / virology
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Oropharyngeal Neoplasms / diagnosis*
  • Oropharyngeal Neoplasms / therapy*
  • Oropharyngeal Neoplasms / virology
  • Papillomavirus Infections / complications
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Retrospective Studies
  • Tomography, X-Ray Computed*