The 5 year relapse is mentioned below. The percentages for recurrences, relapses are in a different resource(s) that I'm not looking for, but just add up the math. If they say HPV postive has about an 85 percent survival rate that leaves 15 percent. In HPV negative, the survival rate is less than 50 percent, so that's where the 58 percent recurrence or relapse comes in.

http://jco.ascopubs.org/content/31/5/520.full

David, I don't know if you seen this when I posted it on 12/13/12, but here is a report made last year by Memorial Sloan Kettering Cancer Center in NYC, to the Journal of Clinical Oncology, questioning wether Erbitux should replace Cisplatin for chemoradiation in Locally Advanced Head and Neck Cancer, outside clinical trials, anytime soon, until further studies are done.

The study also said the combination of Cisplatin and Erbitux had dissapointing results.

http://jco.ascopubs.org/content/early/2012/11/30/JCO.2012.46.9049

Paul, are you sure that link is OK? I can't seem to get to that study.

It works fine for me using my MAC with Firefox.

It works on my iPad. It's also on web search...controversies with HPV deintensification treatment head and neck cancer.

Hi - no someone else here posted it - here - i just read it. I think the context wasn't a higher recurrence rate - but rather the likeliness of a recurrence past 5 years being higher than non HPV h&n cancer. What I gathered from reading it was... Usually - after five years you're pretty safe - but the article suggested this was not so with HPV related oral cancer to me what I gathered from that was - possibly something due to the dormancy of HPV and possibly that the follow up for HPV related patients should be more long term. I don't go hunting down articles so I'm pretty sure it was referenced here.

Hi Paul,

Very nice pick on this reference. I ran it down two levels down and pleasantly surprised full text versions were viewable.

I did get stuck on ref 8 to view the TNM guideline from AJCC cancer staging manual. I suspect it looks not-surprisingly like the one published by NCCN.

One of the serious questions I posed to the RO was the IMRT rad field map and talked me through the rationale to use the advanced contouring and targeting features but be conservative and still radiate no targeted areas at lower dosage in case small cancers exist but not picked up on PET/CT or CT. This provides support to his rational; it is just too early in the game of medical clinical testing and verification to make such "radical" deviation from standard of care protocols.
[quote]O'Sullivan et al12 appropriately highlight the limitations of their observations and recommend further validation in prospective clinical trials. Given our current knowledge, treatment of HPV-associated, locoregionally advanced cancers with anything less than the standard full doses of radiotherapy and concurrent cisplatin should only occur in the context of a clinical trial. To modify treatment components at this juncture may jeopardize a high probability of cure. [/quote]

ABSTRACT http://jco.ascopubs.org/content/31/5/520.full.pdf+html

FULL REPORT http://jco.ascopubs.org/content/31/5/543.full.pdf+html

FYI - on another tangent. This is the first real dive for me into the subject of prognosis. I just started week 3 of concurrent CRT using standard of care protocols and able to feel just seeing some glimmer of light at the end of this journey.

I have only accepted the general statements that HPV 16+ had better responses and outcomes but this is the first time I really looked at numbers. Pleasantly surprised that based on my staging going in and other factors (never smoke, drink) statistically I am 90+ percent of beating this first go around.

Good luck with the treatment, Don Foo.