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Comment & Response
January 16, 2020

Surveillance Outcomes and Intensity of Salvage Therapy Among Human Papillomavirus–Associated Oropharyngeal Cancers—Reply

Author Affiliations
  • 1Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
  • 2Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California
JAMA Otolaryngol Head Neck Surg. 2020;146(3):312-313. doi:10.1001/jamaoto.2019.4194

In Reply We appreciate the inquiry of Arvold and McBride into the recurrence patterns and salvage treatments of the cohort presented in our study.1

To briefly review, there were 22 patients with recurrences in our cohort. Our articles previously described these patients as having 11 locoregional and 12 distant recurrences (1 patient had combined locoregional and distant recurrences).1,2 Nine patients underwent salvage treatment, which we defined as that with curative intent. Of these, 3 were imaging-detected locoregional recurrences, specifically by treatment-assessment PET/CT2 or the first posttreatment PET/CT within 6 months of treatment completion in patients without signs or symptoms of disease persistence. Although PET/CTs after this 6-month period (subsequent surveillance PET/CT) detected 3 additional recurrences, none underwent salvage treatment. The rest of the recurrences that underwent salvage treatment were clinically detected, meaning either by patient symptoms (symptom directed) or physician examination (physician detected).

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