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Initial presentation of human papillomavirus‐related head and neck cancer: A retrospective review
Author(s) -
Khalid Mian B.,
Ting Peter,
Pai Akila,
Russo Jack L.,
Bakst Richard,
Chai Raymond L.,
Teng Marita S.,
Genden Eric M.,
Miles Brett A.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27296
Subject(s) - medicine , cohort , head and neck cancer , retrospective cohort study , cancer , head and neck squamous cell carcinoma , population , sore throat , disease , univariate analysis , incidence (geometry) , oncology , surgery , multivariate analysis , physics , environmental health , optics
Objective Human papillomavirus (HPV) has been identified as a risk factor for oropharyngeal squamous cell carcinoma (OPSCC) and a cause of the recent dramatic rise in the incidence of this disease. HPV‐positive OPSCC typically affects a younger population and has no validated screening test. This study aims to outline the common presenting signs of HPV‐positive OPSCC. Methods We conducted a retrospective single‐institution review on 370 patients who were treated at the Icahn School of Medicine at Mount Sinai, New York City, between April 2007 and November 2015 for OPSCC. We included patients with newly diagnosed OPSCC and sufficient history and physical data in the final analysis. Univariate analysis was used to compare HPV‐positive and HPV‐negative cohorts for demographics, tumor location, tumor staging, initial presentation and symptoms, and physical exam findings. Results Two hundred and seven patients met the inclusion criteria. The most common initial symptoms for OPSCC were neck mass (51.7%) and sore throat (13.0%). The HPV‐positive cohort was more likely to present with a chief complaint of neck mass compared to the HPV‐negative cohort (56.1% vs. 22.2%; P = 0.0015). A positive neck exam was associated with HPV‐positive status (73.9% vs. 40.7%; P = 0.0012). Conclusion HPV‐positive OPSCC is an incipient epidemic, poised to surpass cervical cancer as the most common HPV‐related cancer by 2020. Initial presenting signs may often be mistaken for benign processes. This study provides physicians with a better understanding of initial presentation of patients with HPV‐positive OPSCC, leading to earlier diagnosis and improved outcomes. Level of Evidence 4 Laryngoscope , 129:877–882, 2019