Open AccessHPV and Other Risk Factors: Oropharyngeal Tumor Survival
Author(s) -
Kaschke Oliver,
Zakarneh André,
Knoedler Maren,
Zimmermann Ulrike,
Woelke Katharina,
Keilholz Ulrich
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811415823a111
Subject(s) - medicine , proportional hazards model , tonsil , hazard ratio , tongue , stage (stratigraphy) , oncology , cohort , risk factor , population , gastroenterology , pathology , confidence interval , paleontology , biology , environmental health
Objective Oropharyngeal carcinomas are associated with tobacco smoking and alcohol but also HPV infection. HPV‐associated carcinomas have a more favorable prognosis in contrast to tobacco‐ and alcohol‐induced carcinomas. Frequency and outcome of HPV‐associated oropharyngeal carcinomas (tonsils and base of tongue) in a cohort with high prevalence of smoking are reported. Method A group of 114 patients with oropharyngeal squamous cell carcinomas (60 tonsil tumors, 54 base of tongue tumors) was controlled. Surgery, chemoradiation, or radiotherapy was performed according to the stage of disease. Complete follow‐up was obtained in fall 2010. Histologic slides were retrieved and stained for p16 as HPV association indicator. Results All 114 patients (81% smokers, 64% tumors stained positive for p16, tonsils 73%, base of tongue 54%). With a median follow‐up of 28 months, 31 patients had disease progression and 39 patients died. Three‐year PFS rates were 79% and 52% in patients with p16+ vs p16‐ tumors ( P =. 001 by log‐rank test). In Cox regression analysis, only stage and p16 were independent prognostic factors. For PFS p16 had a hazard ratio (HR) of 0.44% (95% CI, 0.25 to 0.78). Conclusion Even in a European population with high prevalence of tobacco smoking, p16 positivity remains a strong favorable and independent risk factor, as has previously been shown in US cohorts with far lower smoking prevalence.