Circulating Tumor HPV DNA May Aid Risk Assessment With Oropharyngeal Cancer

MONDAY, April 13, 2026 (HealthDay News) -- A blood test for circulating tumor human papillomavirus DNA (ctHPVDNA) may improve risk assessment in patients undergoing surgery for HPV-related oropharyngeal cancer, according to a study published online April 2 in JAMA Otolaryngology-Head & Neck Surgery.Jack L. Birkenbeuel, M.D., from The Ohio State University in Columbus, and colleagues assessed clinicopathologic variables associated with ctHPVDNA before and after surgery. The analysis included 104 patients with HPV-mediated oropharyngeal squamous cell carcinoma treated with upfront surgery.The researchers found that higher estimated glomerular filtration rate (rate ratio [RR], 1.05) and higher pathologic N stage (RR, 12.30) were independently associated with higher preoperative ctHPVDNA levels. Perineural invasion (PNI; RR, 0.23) and pathologic extranodal extension (pENE; RR, 0.11) were associated with lower ctHPVDNA levels. One in five patients (20.2 percent) had detectable postoperative ctHPVDNA, which was associated with more than four positive lymph nodes (odds ratio [OR], 4.86), higher preoperative ctHPVDNA levels (OR, 1.17), PNI (OR, 2.95), and pENE (OR, 3.38). Three of 15 patients (20.0 percent) with detectable postoperative ctHPVDNA experienced recurrence versus eight of 59 patients (13.6 percent) with undetectable ctHPVDNA. Four locoregional recurrences occurred in patients with undetectable postoperative ctHPVDNA who declined guideline-concordant adjuvant therapy."We found that the pretreatment ctDNA levels are influenced by tumor biology and kidney function," coauthor Catherine Haring, M.D., also from The Ohio State University, said in a statement. "Postoperative ctDNA reflects both residual cancer and baseline tumor DNA levels. This means the test needs to be interpreted in context. A positive result after surgery may indicate higher risk, but a negative result does not always mean a patient is in the clear."One author disclosed ties to the biopharmaceutical industry.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Circulating Tumor HPV DNA May Aid Risk Assessment With Oropharyngeal Cancer

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