Long-term survival after distant metastasis in oropharyngeal carcinoma.

5594 Background: The possibility of cure after distant metastases (DM) in oropharyngeal carcinoma (OPC) is uncertain. We conducted a retrospective cohort study to determine outcome and factors predictive of survival after metastasis in patients with OPC. Methods: From 2003-2010, 24 patients definitively treated (96% with concurrent chemo-radiation) at the Massachusetts General Hospital for OPC subsequently developed DM. At initial diagnosis, HPV status was available in 13 patients, 12 of whom were positive; six patients had T4 and 12 N2c-3 disease. Imaging studies pertinent to the diagnosis of DM were re-reviewed; 83% of patients had DM pathologically confirmed. Overall survival (OS) was defined from 1st radiographic evidence of DM to either death or last follow-up. Cox regression was used to evaluate factors predictive of OS after DM. Results: Median time to DM after initial treatment was 8.25 months (range, 1.6-24). Twenty (83%) patients had isolated distant failure; of these, 6 had limited (1 lesion or...