Disease-free survival after salvage therapy for recurrent oropharyngeal squamous cell carcinoma

Background Factors associated with disease-free survival (DFS) after salvage therapy for recurrent oropharyngeal squamous cell carcinoma (SCC) in the context of human papillomavirus (HPV) are poorly understood. Methods A retrospective cohort analysis was conducted of patients with recurrent oropharyngeal SCC with known HPV tumor status who received salvage therapy. Results Eighty-six patients were eligible for analysis. Sixty-four patients (74%) were HPV-positive. In multivariable analysis, HPV-positive tumor status (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.13-0.71; p =.007), clinical response to any salvage therapy (HR = 0.29; 95% CI = 0.11-0.77; p =.01), and surgical salvage (HR = 0.38; 95% CI = 0.16-0.88; p =.02) were associated with improved overall survival (OS). Positive surgical margin was associated with worse DFS after salvage (HR = 8.43; 95% CI = 1.99-35.70; p =.004). Conclusion For recurrent oropharyngeal SCC, HPV-positive tumor status, surgical salvage, and clinical response to salvage therapy are independently associated with improved OS, but not DFS after salvage. Surgical margin is the only independent predictor of DFS.