Prognostic significance of human papillomavirus in oropharyngeal squamous cell carcinomas

Ahmad R. Sedaghat, Zhe Zhang, Shahnaz Begum, Robert Palermo, Simon Best, Karen M. Ulmer, Marshall Levine, Eva Zinreich, Barbara P. Messing, Dorothy Gold, Annie A. Wu, Kevin J. Niparko, Jeanne Kowalski, Richard M. Hirata, John R. Saunders, William H. Westra, Sara Isabel Pai

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives/Hypothesis The human papillomavirus (HPV) has been identified as a causative factor in 20% to 25% of all head and neck squamous cell carcinomas (HNSCC). Ongoing research suggests that the presence of HPV DNA in HNSCC predicts a positive prognosis with respect to disease-free and overall survival. However, most studies have been limited by the heterogeneity in treatment regimens and/or anatomic subsites of tumor origin. In this study, we correlate clinical outcomes with HPV status for patients with oropharyngeal carcinomas who were uniformly treated with a concurrent chemoradiation treatment protocol. Study Design: Retrospective study. Methods Demographic and clinicopathologic parameters, including age at diagnosis, gender, race, smoking and alcohol history, tumor stage and grade, locoregional recurrence, metastatic spread, recurrence-free survival, overall survival and disease- specific death, were obtained from medical charts and established databases. These parameters were correlated with HPV status of the tumors established by in situ hybridization analysis. Results HPV positivity correlated with improved cinical outcomes regarding locoregional control (P = .042), recurrence-free survival (P = .009), overall sur-vival (P = .017), and disease-specific death (P = .09). Advanced T stage was a significant risk factor for recurrence and death independent of HPV status. Conclusions In patients with oropharyngeal carcinoma uniformly treated with chemoradiation, the presence of HPV is a favorable prognostic indicator with respect to recurrence and overall survival. However, advanced T stage was an independent risk factor for recurrence and death that can to some degree offset this benefit.

Original languageEnglish (US)
Pages (from-to)1542-1549
Number of pages8
JournalLaryngoscope
Volume119
Issue number8
DOIs
StatePublished - Aug 1 2009

Keywords

  • Head and neck cancer
  • Human papilloma virus (HPV)
  • Oropharynx

ASJC Scopus subject areas

  • Otorhinolaryngology

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