Development of second primary malignancies after transoral surgery in human papilloma virus‐positive oropharyngeal squamous cell carcinoma

Background Little data exists regarding the incidence of oropharyngeal and upper aerodigestive tract (UADT) second primary malignancies (SPM) among human papilloma virus (HPV)‐positive oropharyngeal squamous cell carcinoma (OPSCC). Here we evaluate SPM rates among patients with HPV‐related OPSCC. Methods A retrospective cohort study of 412 patients with HPV‐related OPSCC who underwent transoral resection +/− adjuvant therapy at a single center between 1996 and 2018. Results Twenty patients (4.9%) developed SPM of the UADT, nine (2.2%) occurring in the oropharynx. Median time to diagnosis was 59.5 months (0–173 months). Risk of SPM was lower for patients receiving adjuvant radiation (aHR: 0.25, 95%CI: 0.08–0.78). There was no difference in overall or disease‐free survival between those with and without SPM. Conclusion The rate of SPM among patients with HPV‐positive OPSCC is lower than reported rates among HPV‐negative OPSCC. To date, this is the largest study evaluating SPM in patients with surgically treated HPV‐positive OPSCC.