Impact of Treatment Time on Outcome for Resected Head and Neck Squamous Cell Carcinoma by HPV Status

Background and Purpose: Prior investigations have demonstrated an inverse correlation between the interval from resection of head and neck squamous cell carcinoma (HNSCC) to radiotherapy (RT) completion (overall treatment time; OTT) and disease control. However, the importance of OTT in human papillomavirus (HPV)-associated HNSCC remains to be determined. This study evaluates whether OTT remains independently associated with cancer control when evaluated by HPV association. Material and Methods: The data of HNSCC patients treated with curative-intent surgical resection followed by RT were collected. Univariable and multivariable analyses were used to assess the effects of HPV association and OTT. Results: From 2002-2014, 73 eligible patients were identified (36 HPV-associated). The median OTT was 94 days (range, 69-185, with no difference between HPV subgroups). At a median follow-up of 34.9 months (range, 2.6-162.2), 21 patients experienced disease failure, and 25 died. HPV-association was linked to improved disease-free survival (DFS), disease-specific survival (DFS), and overall survival (OS) by univariable and multivariable analyses. OTT was associated with improved DFS by univariable and multivariable analyses. Conclusion: OTT remains significantly associated with cancer control in the setting of HPV-associated disease. Efforts should be made to minimize the delay between resection and completion of RT for all HNSCC patients.

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