Impact of routine surveillance imaging on detecting recurrence in human papillomavirus associated oropharyngeal cancer

•HPV associated oropharyngeal cancer patients have low failure rates after definitive treatment.•Nearly all recurrences occur within the first 2–3 years post treatment.•Surveillance imaging for recurrences seems most useful in the first 3 years post treatment.•Surveillance imaging for second primaries has low yield. This study examines the utility of surveillance imaging in detecting locoregional failures (LRF), distant failures (DF) and second primary tumors (SPT) in patients with human papillomavirus (HPV) associated oropharyngeal cancer (OPC) after definitive chemoradiotherapy (CRT). An institutional database identified 225 patients with biopsy proven, non- metastatic HPV+ OPC treated with definitive CRT between 2004 and 2015, whose initial post-treatment imaging was negative for disease recurrence (DR). Two groups were defined: patients with