Head and Neck

Prognostic significance of human papillomavirus in oropharyngeal squamous cell carcinomas†‡

  1. Ahmad R. Sedaghat MD, PhD1,
  2. Zhe Zhang MS2,
  3. Shahnaz Begum PhD1,3,
  4. Robert Palermo MD4,
  5. Simon Best MD4,
  6. Karen M. Ulmer RN4,
  7. Marshall Levine MD4,
  8. Eva Zinreich MD4,
  9. Barbara P. Messing MA, CCC-SLP4,
  10. Dorothy Gold4,
  11. Annie A. Wu1,
  12. Kevin J. Niparko1,
  13. Jeanne Kowalski PhD2,
  14. Richard M. Hirata MD1,4,
  15. John R. Saunders MD1,4,
  16. William H. Westra MD1,3,
  17. Sara I. Pai MD, PhD1,*

Article first published online: 11 JUN 2009

DOI: 10.1002/lary.20533

Issue

The Laryngoscope

The Laryngoscope

Volume 119, Issue 8, pages 1542–1549, August 2009

Additional Information

How to Cite

Sedaghat, A. R., Zhang, Z., Begum, S., Palermo, R., Best, S., Ulmer, K. M., Levine, M., Zinreich, E., Messing, B. P., Gold, D., Wu, A. A., Niparko, K. J., Kowalski, J., Hirata, R. M., Saunders, J. R., Westra, W. H. and Pai, S. I. (2009), Prognostic significance of human papillomavirus in oropharyngeal squamous cell carcinomas. The Laryngoscope, 119: 1542–1549. doi: 10.1002/lary.20533

Author Information

  1. 1

    Department of Otolaryngology/Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.

  2. 2

    Department of Oncology Biostatistics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.

  3. 3

    Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.

  4. 4

    The Milton J. Dance, Jr. Head and Neck Center at Greater Baltimore Medical Center, Baltimore, Maryland, U.S.A.

*Department of Otolaryngology/Head and Neck Surgery, Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD 21287

  1. †

    This work was supported by The Milton J. Dance, Jr. Head and Neck Center at Greater Baltimore Medical Center Neck Center, Baltimore, Maryland.

  2. ‡

    The authors have no conflicting financial interests.

Publication History

  1. Issue published online: 21 JUL 2009
  2. Article first published online: 11 JUN 2009
  3. Manuscript Accepted: 15 APR 2009
  4. Manuscript Revised: 10 APR 2009
  5. Manuscript Received: 10 FEB 2009

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Keywords:

  • Human papilloma virus (HPV);
  • head and neck cancer;
  • oropharynx

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 clinical outcomes regarding locoregional control (P = .042), recurrence-free survival (P = .009), overall survival (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.

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