The impact of HPV infection, smoking history, age and operability of the patient on disease-specific survival in a geographically defined cohort of patients with oropharyngeal squamous cell carcinoma. (September 2014)

• Record Type: Journal Article
• Authors: Ljøkjel, Borghild; Haave, Hilde; Lybak, Stein; Aarstad, Helene H.; Karlsdottir, Àsa; Vintermyr, Olav K.; Aarstad, Hans Jørgen
• Is Part Of: Acta oto-laryngologica. Volume 134:Number 9(2014)
• Page Start: 964
• Page End: 973
• Publication Date: 2014-09
• Subjects: Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.3109/00016489.2014.927590
• Languages: English
• ISSNs: 0001-6489

Abstract

<abstract> <title>Abstract</title> <p> <italic>Conclusions:</italic> Patients with human papillomavirus (HPV)-positive tumours had better 5-year disease-specific survival (DSS) than HPV-negative patients. TNM score only predicted prognosis among HPV-negative patients. A previous history of smoking and age at diagnosis predicted DSS among HPV-positive patients whereas operability at diagnosis predicted DSS among both HPV-positive and HPV-negative patients. <italic>Objectives:</italic> HPV is a risk factor for oropharyngeal squamous cell carcinoma (OPSCC). The extent to which smoking, age and operability could play a role in HPV-positive surgically treated head and neck SCCs has not been extensively addressed previously and this study aimed to evaluate these factors. <italic>Methods:</italic> We identified 232 patients with OPSCC, of which 186 from the tonsil or base of the tongue region were treated in the period 1992–2008 in Western Norway. The 5-year DSS was recorded. Details on smoking history and whether the lesion was operable or not, as well as clinical information, were obtained retrospectively from the hospital records. <italic>Results:</italic> TNM stage predicted survival only among HPV-negative patients. A previous smoking affected prognosis only among HPV-positive patients (relative risk (RR) = 2.5; confidence interval (CI) = 1.0–6.2; <italic>p</italic> = 0.05). Increasing age of the patient had a negative effect on survival in HPV-positive patients only, especially among the oldest quartile (RR = 4.4; CI = 2.0–9.0; <italic>p</italic> < 0.001). Whether the tumour was operable or not uniquely predicted DSS both among HPV-positive (RR = 0.34; CI = 0.13–0.93; <italic>p</italic> < 0.05) and HPV-negative (RR = 0.25; CI = 0.10–0.66; <italic>p</italic> < 0.01) patients with tonsil/base of the tongue SCC.</p> </abstract>