ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Circulating tumor HPV DNA versus PET-CT for surveillance in oropharyngeal squamous cell carcinoma: a systematic review and meta-analysis.
Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
purposeTo evaluate the diagnostic performance of circulating tumor HPVDNA (ctHPVDNA) for detecting residual or recurrent disease in patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) compared with positron emission tomography–computed tomography (PET-CT).
methodsData sources, including MEDLINE, Embase, CENTRAL, and Scopus, were searched from 2015 to May 2025 for studies evaluating the detection of circulating tumor DNA after treatment for HPV-positive OPSCC, using PET-CT as the reference standard. A systematic review and meta-analysis were conducted and registered with PROSPERO (CRD420251037973). Two reviewers independently extracted data according to the PRISMA guidelines and assessed quality using the QUADAS-2 tool. A hierarchical random-effects model was used to estimate pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios (DORs).
resultsTen studies comprising 596 patients met the inclusion criteria. Pooled sensitivity for ctHPVDNA was 0.86 (95% CI, 0.68–0.95), specificity was 0.96 (95% CI, 0.88–0.99), and DOR was 153.0 (95% CI, 45.3–516.1). Subgroup analyses revealed the highest performance in studies using droplet digital polymerase chain reaction (ddPCR) and in those with sampling times greater than 12 weeks after treatment. PET-CT showed sensitivity of 0.89 (95% CI, 0.81–0.94) and specificity of 0.83 (95% CI, 0.30–0.98), with greater heterogeneity driven by threshold effects.
conclusionsctHPV DNA demonstrates high specificity and good sensitivity for detecting post-treatment recurrence in HPV-positive OPSCC, outperforming PET-CT in specificity and complementing its role in surveillance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.