Patients with human papillomavirus (HPV)–associated oropharyngeal squamous cell carcinoma (OPSCC) who adhered to the posttreatment clinical surveillance recommendations from the National Comprehensive Cancer Network® (NCCN®) did not appear to benefit from improved survival, a retrospective cohort study found. The findings were recently published in JAMA Otolaryngology–Head & Neck Surgery.1
Using the Kaiser Permanente Northern California tumor registry, the study researchers retrospectively identified 233 patients with HPV-associated OPSCC who were eligible for the analysis. Medical records were reviewed to obtain information about tumor recurrences and second primary cancers, and the State of California Death Certificates database was used to obtain all-cause mortality and dates of death.
The NCCN guidelines recommend patients adhere to the following clinical surveillance schedule once treatment is completed: every 1 to 3 months during year 1, every 2 to 6 months during year 2, every 4 to 8 months during years 3 to 5, and then once per year.
Adherence to these guidelines was assessed, revealing that 83.0% of the patients adhered to the guidelines during year 1, 52.7% during year 2, 73.4% during year 3, 62.3% during year 4, and 52.9% during year 5. In all, 3358 clinical surveillance examinations were conducted and recurrences were found in 10 patients who had symptoms and 1 who did not; an additional 11 recurrences were detected using surveillance imaging, bringing the total to 22 patients representing 23 recurrences.
Overall, 19 of the 22 patients (86.4%) adhered to the surveillance recommendations before diagnosis. A multivariate analysis revealed that adherence to the recommendations before diagnosis was not associated with an improved survival (adjusted hazard ratio=0.62; 95% CI, 0.17-2.30).
“Adherence to the current schedule does not appear to confer survival advantage,” the study authors wrote in conclusion. “These findings support reduction of posttreatment clinical surveillance in this population.”
Masroor F, Corpman D, Carpenter DM, et al. Association of NCCN-recommended posttreatment surveillance with outcomes in patients with HPV–associated oropharyngeal squamous cell carcinoma [published online August 8, 2019]. JAMA Otolaryngol Head Neck Surg. doi: 10.1001/jamaoto.2019.1934