(0719) Recurrence Characteristics of HPV-Associated Oropharyngeal Squamous Cell Carcinoma: A Scoping Review

Introduction: Despite the improved prognosis of HPV+ OPSCC, approximately between 10 and 30% of patients experience disease recurrence. Herein we present a scoping review of the literature studying patterns of recurrence in HPV+ OPSCC in an effort to provide further evidence of the metastatic pattern of this disease type and outline the most effective types of salvage therapy after disease recurrence.

Methods: We conducted a scoping review through the Ovid MEDLINE research database. Two reviewers independently evaluated the 574 articles that were outputted by MEDLINE. Of them, 546 articles were excluded based on title, 8 articles were subsequently excluded based on abstract, and 11 articles were subsequently excluded based on full-text evaluation.

Results: In total, 9 full-text articles met the inclusion criteria. The average recurrence rate across all studies was 15.1%. While all studies found the lung as the most common DM site, HPV+ OPSCC DMs were additionally found in the liver (8 studies), bone (8 studies), brain or CNS (6 studies), skin (3 studies), visceral organs (2 studies) and spine (2 studies). The longest reported time to recurrence was 194.8 months (Su 2020), and 2 other studies reported recurrences beyond 90 months since initial treatment. Overall survival data was heterogeneously reported across the 9 studies, but 5 out of 6 studies that included data on salvage treatment endorsed the idea that recurrent disease treated with curative-intent salvage therapy generally yields successful outcomes and should always be attempted as tolerated.

Conclusions: HPV+ OPSCC is universally found to be a more favorable disease than its HPV- counterpart, though with potentially clinically important differences in DM pattern and TTR. Most patients, especially those with solitary DMs or regional recurrences in previously untreated sites responded well to curative-intent salvage therapy. There remains insufficient detail in the literature describing how recurrences were detected (i.e. symptom-driven imaging or screening imaging).