Distant metastases in human papillomavirus‐related oropharyngeal squamous cell carcinoma: Systematic review and meta‐analysis

The prevalence of distant metastases (DM) in human papillomavirus (HPV)‐related oropharyngeal squamous cell carcinoma (OPSCC) remains unknown. A PRISMA systematic review of DM rates in patients with HPV‐related OPSCC was performed. PubMed‐MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched. The primary outcome was prevalence of DM. Data on demographics, tumor classification, and clinical outcomes were also collected. Meta‐analysis of pooled DM rate was determined. Ten articles met inclusion criteria, representing 1860 patients with mean follow‐up of 3.6 years. Overall DM rate was 7.0% (95% CI: 5.9–8.2). T3 or T4 classification disease was associated with a 4.88‐fold (95% CI: 1.92–12.40) risk of DM compared to T1 or T2 classification disease. This study is the first to systematically review the prevalence of DM among patients with HPV‐related OPSCC, where pooled DM rate was found to be 7%.