Nodal status is not a prognostic factor in patients with HPV-positive oral/oropharyngeal tumors

J Surg Oncol. 2013 May;107(6):625-33. doi: 10.1002/jso.23292. Epub 2012 Nov 28.

Abstract

Objectives: The primary aim is to compare the prognostic parameters in patients with HPV-positive and HPV-negative tumors. The secondary aim is to compare the patterns of treatment failure between these groups.

Methods: Analysis of prognostic factors in a group of 170 patients.

Results: High-risk HPV DNA was detected in 98 cases, 72 tumors were HPV negative. Both the overall and disease-specific survival rates were better in HPV-positive patients. In patients with HPV-negative tumors, the prognostic factors in univariate analysis were pT and pN classification, tumor stage, number of positive nodes, and extracapsular spread. Stage, pT, higher pN, and number of nodes maintained statistical significance after adjustment. None of the studied prognostic factors was significant in the group of patients with HPV-positive tumors. There was a significant difference in the local--regional recurrence rates--37% in HPV-negative cases and 18% in HPV-positive cases.

Conclusion: The characteristics of the extent of the disease in general and of regional lymph node metastasis in particular are probably much less important in the prediction of the outcome of HPV-positive than of HPV-negative tumors. Improved survival of patients with HPV-positive tumors is due mostly to the difference in the local-regional failure rates.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alphapapillomavirus / genetics
  • Alphapapillomavirus / isolation & purification*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology*
  • DNA, Viral
  • Female
  • Follow-Up Studies
  • Human Papillomavirus DNA Tests
  • Humans
  • Logistic Models
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery
  • Mouth Neoplasms / virology*
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / virology
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / surgery
  • Oropharyngeal Neoplasms / virology*
  • Prognosis
  • Prospective Studies
  • Survival Analysis
  • Treatment Failure

Substances

  • DNA, Viral