Human
papillomavirus (HPV)-positive tumor status is associated with a significantly
better rate of overall survival in patients with oropharyngeal squamous cell
carcinoma (OPSCC) that has progressed, according to Carole Fakhry, MD, and colleagues
of Johns Hopkins Medical Center, Baltimore, Maryland.
Previous
studies has shown reduced risk of cancer progression in patients with newly
diagnosed local-regionally HPV-positive OPSCC. However, no information was
available regarding the role of the HPV status in overall survival after cancer
had progressed.
The
retrospective study evaluated 181 patients with stage III-IV OPSCC, and
included 105 who were HPV-positive and 76 who were HPV-negative.
Even
though no difference was found in the median time to progression in relation to
the HPV tumor status (8.2 vs 7.3 months; P = .67), HPV-positive OPSCC had
significantly improved rates of overall survival at 2 years compared with
HPV-negative patients (54.6% vs 27.6%; P< .001).
Factors
significantly associated with increased risk of death included high tumor stage
(T4 vs T2-3) at diagnosis, fewer cisplatin treatment cycles (≤1 vs 2-3), and
distant versus local/regional recurrence. Smoking was also an important risk
factor, with the risk of death after progression increased by 1% per cigarette
pack-year at diagnosis (P = .002).
Significant
reductions in the risk of death were associated with HPV-positive tumor status
and undergoing salvage surgery. The overall rate of mortality was reduced by
50% in individual with HPV-positive tumors.
Sites of HPV oral cancer