Factors associated with detection of oligometastatic recurrence and outcome following definitive (Chemo)radiotherapy for oropharyngeal carcinoma
Bibliographic record
Abstract
PURPOSE/BACKGROUND: We aim to describe characteristics and patterns of detection of distant metastasis (DM) and subsequent outcomes following definitive (chemo)radiotherapy [(C)RT] for oropharyngeal cancer (OPC). MATERIAL/METHODS: OPC patients who developed DM after initial complete response to (C)RT from 2010 to 2020 were included. DM were classified as oligometastases (≤5 lesions) vs polymetastases. Interval from prior normal surveillance imaging to DM detection was recorded. Multivariable analysis (MVA) was performed for overall survival (OS) after DM. RESULTS: A total of 124 patients were eligible. Most (116/124, 94 %) developed DMs within the thorax, of whom 72 (58 %) had thorax only DM. Oligometastases (n = 46) vs polymetastases (n = 78) were more commonly detected without DM-related symptoms (76 % vs 55 %, p = 0.003) and identified with shorter interval from previous normal imaging (median 7.9 vs 12.7 months, p = 0.030). Median follow-up from DM diagnosis was 31.5 months. Three-year OS after DM was higher for patients with oligometastases vs polymetastases (32 % vs 5 %, p < 0.001). Patients with oligometastases who received salvage therapy had a longer 3-year OS (vs not) (63 % vs 7 %, p < 0.001). On MVA, salvage therapy (Hazard Ratio [HR) 0.32, p = 0.005), HPV + status (HR 0.50, p = 0.002) and thorax only distant metastases (HR 0.64, p = 0.034) were associated with longer OS. CONCLUSIONS: Nearly one-third of first DM in OPC following initial complete response to (C)RT are oligometastases and most occur within the thorax. Most oligometastases are asymptomatic and more commonly detected following a shorter surveillance scan interval. DM-targeted salvage therapy for oligometastases is associated with longer OS. Prospective studies refining surveillance algorithms to increase detection of oligometastases in asymptomatic high-risk OPC patients are indicated.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".