The impact of HPV infection on survival in a geographically defined cohort of oropharynx squamous cell carcinoma (OPSCC) patients in whom surgical treatment has been one main treatment

• Published in: Acta oto-laryngologica 2014-06, Vol.134 (6), p.636-645
• Main Authors: Ljøkjel, Borghild, Lybak, Stein, Haave, Hilde, Olofsson, Jan, Vintermyr, Olav K., Aarstad, Hans Jørgen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - surgery; Carcinoma, Squamous Cell - virology; Cohort Studies; Female; Head and neck cancer; Human papillomavirus; Humans; Male; Middle Aged; neoplasms; Norway - epidemiology; Oropharyngeal Neoplasms - mortality; Oropharyngeal Neoplasms - surgery; Oropharyngeal Neoplasms - virology; oropharynx; Papillomavirus Infections - complications; Papillomavirus Infections - mortality; Papillomavirus Infections - pathology; Prognosis; Survival Rate; TNM stage
• ISSN: 0001-6489; 1651-2251
• DOI: 10.3109/00016489.2014.886336

Abstract Conclusions: We determined that 55% of the patients with oropharynx squamous cell carcinoma (OPSCC) had human papilloma virus (HPV)-positive tumors. We demonstrated that HPV-positive patients had better 5-year disease-specific survival (DSS) than the HPV-negative counterparts. This was also primarily true for cancers originating in the tonsil or base of the tongue with T3 and/or N2 tumors. Objective: Urogenital high risk (hr) HPV is an important risk factor, and probably causative agent, for OPSCC. The study investigated these factors. Methods: We identified 232 patients with OPSCC, of which 186 lesions were from the tonsil or base of the tongue region, treated in the period 1992-2008 in Western Norway. Five-year DSS was recorded for all patients. Results: In all, 124 of 226 patients had HPV-positive tumors. All except five HPV-positive patients had HPV-16-positive tumors; 69% of the patients with tonsil or base of the tongue SCC had HPV-positive tumors, whereas 14% of remaining OPSCC patients had HPV-positive tumors. Five-year DSS with HPV-positive tumor was 77% compared with 53% with an HPV-negative tumor (p < 0.001), also valid with adjustment for age, gender, and TNM stage, but primarily determined with patients with the specific tumor sites tonsils and base of the tongue with TNM stages T3 or N2.