☆ 4.6 Article

Human Papillomavirus-16 Infection in Advanced Oral Cavity Cancer Patients Is Related to an Increased Risk of Distant Metastases and Poor Survival

PLOS ONE (2012)

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PLOS ONE

卷 7, 期 7, 页码 -

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PUBLIC LIBRARY SCIENCE

DOI: 10.1371/journal.pone.0040767

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Multidisciplinary Sciences

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Department of Health, Taiwan [DOH100-TD-C-111-006]
Chang Gung Memorial Hospital in Linkou, Taoyuan, Taiwan [CMRPG391431/391432]

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Background: Human papillomavirus (HPV) is an oncogenic virus causing oropharyngeal cancers and resulting in a favorable outcome after the treatment. The role of HPV in oral cavity squamous cell carcinoma (OSCC) remains ambiguous. Objective: This study aimed to examine the effect of HPV infection on disease control among patients with OSCC following radical surgery with radiation-based adjuvant therapy. Patients and Method: We prospectively followed 173 patients with advanced OSCC (96% were stage III/IV) who had undergone radical surgery and adjuvant therapy between 2004 and 2006. They were followed between surgery and death or up to 60 months. Surgical specimens were examined using a PCR-based HPV blot test. The primary endpoints were the risk of relapse and the time to relapse; the secondary endpoints were disease-free survival, disease-specific survival, and overall survival. Results: The prevalence of HPV-positive OSCC was 22%; HPV-16 (9%) and HPV-18 (7%) were the genotypes most commonly encountered. Solitary HPV-16 infection was a poor predictor of 5-year distant metastases (hazard ratio, 3.4; 95% confidence interval, 1.4-8.0; P = 0.005), disease-free survival (P = 0.037), disease-specific survival (P = 0.006), and overall survival (P = 0.010), whereas HPV-18 infection had no impact on 5-year outcomes. The rate of 5-year distant metastases was significantly higher in the HPV-16 or level IV/V metastasis group compared with both the extracapsular spread or tumor depth >11-mm group and patients without risk factors (P<0.001). Conclusions: HPV infections in advanced OSCC patients are not uncommon and clinically relevant. Compared with HPV-16-negative advanced OSCC patients, those with a single HPV-16 infection are at higher risk of distant metastases and poor survival despite undergoing radiation-based adjuvant therapy and require a more aggressive adjuvant treatment and a more thorough follow-up.

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Oropharyngeal squamous cell carcinoma: Prognostic factors for development of distant metastases and oncological outcomes

Francesco Mattioli, Alfredo Lo Manto, Matteo Miglio, Edoardo Serafini, Davide Rossi, Sara Valerini, Roberto Tonelli, Matteo Fermi, Giuseppe Pugliese, Federica Bertolini, Elisa D'Angelo, Roberta Depenni, Massimo Dominici, Frank R. H. Lohr, Daniele Marchioni

Summary: 14% of patients with oropharyngeal squamous cell carcinoma (OPSCC) develop distant metastasis, and p16+ OPSCC patients have a greater impact from distant metastasis. Patients with lung metastasis have better overall survival compared to those with non-pulmonary metastases.

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