The increasing number of patients under surveillance after treatment of human papillomavirus-related oropharyngeal squamous cell carcinoma (OPSCC) places a great burden on healthcare providers. The aim of this study was to explore OPSCC recurrences in a long follow-up period: their site, frequency and timepoint after primary treatment, treatment and outcome. The secondary aim was to investigate if the recurrences are diagnosed on routine follow-up visits, and if the p16 status will have an effect on the pattern of recurrences. We analyzed recurrences within a 10-year follow-up period after completed curatively intended treatment among OPSCC patients in Finland treated between 2000 and 2009. Patient-, tumor-, treatment- and follow-up -related parameters were investigated. Out of 495 patients with no residual tumor during the first six months, 71 (14%) were diagnosed with a recurrence, of which 47 were locoregional and 28 were treated with curative intent. Of the recurrences, 86% were diagnosed during the first 36 months after primary treatment. Only ten recurrences appeared after 36 months. The median OS after recurrence was 10.9 months. Routine follow-up longer than three years after treatment seems not to be effective in terms of detecting OPSCC recurrences.
背景:人乳头瘤病毒相关口咽鳞状细胞癌 (OPSCC) 治疗后接受监测的患者数量不断增加, 给医疗保健提供者带来了沉重负担。 目的:本研究的目的是探讨 OPSCC 在长期随访期间的复发:初级治疗后的部位、频率和时间点、治疗和结果。第二个目的是调查是否在常规随访中诊断出复发, 以及 p16 状态是否会对复发模式产生影响。 材料和方法:我们分析了 2000 年至 2009 年间接受治疗的芬兰 OPSCC 患者完成根治性治疗后 10 年随访期内的复发情况。调查了患者、肿瘤、治疗和随访等相关的参数。 结果:在前六个月内没有残留肿瘤的 495 名患者中, 有 71 名 (14%) 被诊断为复发, 其中 47 名是局部区域性的, 28 名接受了根治性治疗。 在复发病例中, 86% 是在初次治疗后的前 36 个月内诊断出来的。 36 个月后仅出现 10 例复发。 复发后的中位 OS 为 10.9 个月。 结论和意义:就检测 OPSCC 复发而言, 治疗后三年以上的常规随访似乎不起作用。