{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:28:12Z","timestamp":1783571292744,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Tumor\u2010tissue modified viral (TTMV)\u2010human papillomavirus (HPV) DNA is an increasingly utilized biomarker for patients with HPV\u2010mediated oropharyngeal squamous cell carcinoma (OPSCC). However, much remains to be studied regarding the quantitative importance of a positive pre\u2010treatment result and correlations with disease burden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single tertiary care center; January 2022 to July 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with HPV\u2010associated OPSCC and baseline pre\u2010treatment TTMV\u2010HPV DNA levels were evaluated for primary tumor and lymph node disease extent on clinical imaging, exam, and surgical pathology results when applicable. Associations with log(pre\u2010treatment TTMV\u2010HPV DNA levels) were evaluated via multivariable linear regression. A commercially available TTMV\u2010HPV DNA test was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 94 patients were included, who were 93% male, with median age of 63 years (interquartile range [IQR] 55\u201070). Most patients were clinical tumor class cT1 (40%) or cT2 (38%) and clinical nodal class cN1 (77%). Surgical resection was performed in 37% of patients. Median pretreatment TTMV\u2010HPV level was 225 (IQR 46\u20101132) fragments\/mL. Independent associations were found between pretreatment TTMV\u2010HPV levels and clinical nodal staging (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), largest lymph node dimension on pretreatment CT (<jats:italic>r<\/jats:italic>\u2009=\u20090.63 [95% confidence interval [CI]: 0.46\u20101.2]; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and surgical pathology (<jats:italic>r<\/jats:italic>\u2009=\u20090.63 [0.18\u20101.08; <jats:italic>P<\/jats:italic>\u2009=\u2009.01), number of metastatic nodes on CT (<jats:italic>r<\/jats:italic>\u2009=\u20090.52 [0.2\u20100.84]; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), clinical signs of extranodal extension (<jats:italic>r<\/jats:italic>\u2009=\u20091.66 [0.12\u20103.2]; <jats:italic>P<\/jats:italic>\u2009=\u20090.04), and SUV\u2010max of lymph nodes (<jats:italic>r<\/jats:italic>\u2009=\u20090.16 [0.05\u20130.27]; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre\u2010treatment TTMV\u2010HPV DNA was significantly associated with lymph node disease burden in HPV\u2010associated OPSCC, on pre\u2010treatment CT, PET, and surgical pathology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1345","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T02:04:34Z","timestamp":1751940274000},"page":"911-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Circulating Tumor Tissue\u2010Modified\u2010Viral HPV DNA and Correlations With Disease Burden in Oropharyngeal Cancer"],"prefix":"10.1002","volume":"173","author":[{"given":"Jaclyn","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Vanderbilt University Medical Center Nashville Tennessee 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Lockney","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Vanderbilt University Medical Center Nashville Tennessee USA"},{"name":"Department of Radiation Oncology Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Vanderbilt University Medical Center Nashville Tennessee USA"},{"name":"Department of Radiation Oncology Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1022-4417","authenticated-orcid":false,"given":"Michael C.","family":"Topf","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck 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