Postoperative Lymph ctDNA for Detection of Recurrence in HPV-negative Head and Neck Cancer

Relapse is a major cause of failure after surgery in human papillomavirus (HPV) negative head and neck squamous cell carcinoma (HNSCC), with up to 50% of patients recurring within 2 years. Clinicopathologic criteria for adjuvant treatment are imprecise and have not changed for decades. Additional molecular biomarkers available within the adjuvant-decision making window have the potential to augment treatment decisions. We investigated whether circulating tumor DNA (ctDNA) in lymphatic exudate collected via surgical drains ("lymph") 24 hours after surgery identified molecular residual disease (MRD) and compared its performance to time-matched plasma in two cohorts of HPV- HNSCC patients.