The Lack of Standardized Outcomes for Surgical Salvage of HPV-Positive Recurrent Oropharyngeal Squamous Cell Carcinoma: A Systematic Scoping Review

SIMPLE SUMMARY: Despite salvage surgery being a key treatment option for recurrent oropharyngeal squamous cell carcinoma, it is unclear how human papillomavirus (HPV) status affects survival rates. The aim of this study was to evaluate how salvage surgery impacts patient survival in the setting of HPV oropharyngeal cancer that recurred within the head and neck region. This scoping review of 32 studies found that only 18.8% of these articles evaluated survival data specific to salvage surgery patients, and 4 studies inconsistently reported survival endpoints, such as overall survival. These findings suggest that future studies can improve upon survival reporting to guide clinical management decisions for HPV-positive recurrent oropharyngeal cancer. ABSTRACT: Although HPV status is known to provide an improved prognosis in initial treatments of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC), it is unclear how it affects patients who receive salvage surgery (SS), which has historically poor survival rates. The purpose of this study was to evaluate the role of SS for patients with locoregional recurrence (LRR) of HPV-positive OPSCC and its impact survival rates. We conducted a scoping review of literature through October 2022 and included 995 individuals. Survival endpoints, such as overall survival (OS), Kaplan–Meier curves, and median post-recurrence survival, were analyzed in addition to demographics. Of all studies, 18.8% (6/32) reported any survival data for SS patients, with the most prevalent reporting 2- and 5-year OS in two studies. Median post-recurrence survival was not reported for SS. These findings reveal the limited and unpredictable reporting of survival-specific data on SS for HPV-positive OPSCC. With limited survival assessment, it is difficult to assess the potential advantages and disadvantages of this therapy to guide clinical decision-making.