Postoperative ctDNA could potentially spare patients from unnecessary adjuvant therapy in HPV-negative head and neck squamous cell carcinoma: a meta-analysis
5 affiliations
- 1Department of Basic Medical Science, Majmaah University
- 2Facultad de Medicina, Universidad Mayor de San Andres
- 3Department of General Surgery, The Rotherham National Health Service (NHS), Rotherham General Hospital
- 4Faculty of Allied Medical Sciences, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University
- 5Department of Precision Medicine, University of Campania “Luigi Vanvitelli”
Abstract
Background: The prognostic utility of circulating tumor DNA (ctDNA) for minimal residual disease detection in human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC) remains incompletely characterized. This meta-analysis evaluates the association between post-operative ctDNA and recurrence-free survival (RFS) in this population.
Methods: A systematic search of major databases through May 2026 identified studies evaluating post-operative ctDNA and RFS in HPV-negative HNSCC. Pooled hazard ratios (HRs) were calculated using a random-effects model.
Results: Eight studies (n=325) were included. Detectable post-operative ctDNA was associated with diminished RFS (HR = 10.07, 95% CI: 5.64–17.99) and overall survival (HR = 8.98, 95% CI: 2.93–27.58). However, sensitivity analyses substantially attenuated the pooled RFS estimate (HR range: 2.22–2.43), suggesting the primary effect magnitude may lack stability.
Conclusions: While preliminary evidence suggests an association between post-operative ctDNA and recurrence risk in HPV-negative HNSCC, these findings require cautious interpretation. The current literature is constrained by small sample sizes, heterogeneous detection methodologies, mixed-cohort inclusion, and potential confounding biases. Consequently, post-operative ctDNA remains an investigational biomarker in this setting. Clinical implementation necessitates further validation through large, prospective, multi-institutional studies employing standardized methodologies in strictly defined HPV-negative #146;populations.
Related
- Exploring the relationship between oral microbiome and postoperative delirium in patients with oral squamous cell carcinoma
- Quality improvement project to reduce the unnecessary use of urinary catheters in patients cared for by a community nursing team
- Real-world perioperative systemic treatment patterns and postoperative mortality in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy in Japan: WAKKA-UTUC study
- Retrospective comparative study of early postoperative complications and recovery following modified gasless subclavian endoscopic thyroidectomy in patients with papillary thyroid carcinoma at different tumor stages.
- Adjuvant and Perioperative Systemic Therapy for Resectable Hepatocellular Carcinoma: Evidence, Biological Rationale, and Trial Design
BibTeX
@article{asad2026postoperative,
title = {{Postoperative ctDNA could potentially spare patients from unnecessary adjuvant therapy in HPV-negative head and neck squamous cell carcinoma: a meta-analysis}},
author = {Mohammad Rehan Asad and Alejandra Flores Pusarico and Nidhi Reji and Tareq Nayef AlRamadneh and Atta Ullah Khan},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1902328},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1902328/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Postoperative ctDNA could potentially spare patients from unnecessary adjuvant therapy in HPV-negative head and neck squamous cell carcinoma: a meta-analysis
AU - Mohammad Rehan Asad
AU - Alejandra Flores Pusarico
AU - Nidhi Reji
AU - Tareq Nayef AlRamadneh
AU - Atta Ullah Khan
PY - 2026
DA - 2026/10/16
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1902328
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1902328/full
AB - Background: The prognostic utility of circulating tumor DNA (ctDNA) for minimal residual disease detection in human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC) remains incompletely characterized. This meta-analysis evaluates the association between post-operative ctDNA and recurrence-free survival (RFS) in this population. Methods: A systematic search of major databases through May 2026 identified studies evaluating post-operative ctDNA and RFS in HPV-negative HNSCC. Pooled hazard ratios (HRs) were calculated using a random-effects model. Results: Eight studies (n=325) were included. Detectable post-operative ctDNA was associated with diminished RFS (HR = 10.07, 95% CI: 5.64–17.99) and overall survival (HR = 8.98, 95% CI: 2.93–27.58). However, sensitivity analyses substantially attenuated the pooled RFS estimate (HR range: 2.22–2.43), suggesting the primary effect magnitude may lack stability. Conclusions: While preliminary evidence suggests an association between post-operative ctDNA and recurrence risk in HPV-negative HNSCC, these findings require cautious interpretation. The current literature is constrained by small sample sizes, heterogeneous detection methodologies, mixed-cohort inclusion, and potential confounding biases. Consequently, post-operative ctDNA remains an investigational biomarker in this setting. Clinical implementation necessitates further validation through large, prospective, multi-institutional studies employing standardized methodologies in strictly defined HPV-negative #146;populations.
SN - 2234-943X
ER -