Effect of HPV on Posttreatment Weight in Head and Neck Squamous‐Cell Carcinoma: A Pilot Study. (2nd September 2014)

• Record Type: Journal Article
• Authors: Zhang, Zi; O'Malley, Bert W.; Brown, Justin C.; Bauml, Joshua; Dean, Lorraine T.; Weinstein, Gregory S.; Schmitz, Kathryn H.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 151(2014)Supplement 1
• Page Start: P162
• Page End: P162
• Publication Date: 2014-09-02
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814541629a78
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Unlike head and neck squamous cell carcinoma (HNSCC) caused by tobacco and alcohol use, human papillomavirus (HPV)–related HNSCC has better survival outcomes. The aim of our study was to determine if post‐treatment weight change was different between HPV positive and negative oral tongue and oropharyngeal squamous cell carcinoma (OPC) patients. Methods: We conducted a retrospective cohort study. Oral tongue and OPC patients with initial surgery or radiation/chemotherapy in 2010 were identified using the University of Pennsylvania Tumor Registry. Those with p16 testing as a surrogate marker for high‐risk HPV were enrolled. Patient characteristics at diagnosis were collected, and the outcomes were mean weights at pretreatment and 0‐6, 6‐12, 12‐18, and 18‐24 month posttreatment visits. Results: We identified 50 survivors with p16 testing and follow‐up weights. Seventy‐four percent (n = 37) were p16‐positive. Compared with p16‐negative patients, p16‐positive patients were significantly more likely to be younger (56 ± 11 vs 72 ± 12, P =. 0001), at AJCC TNM stage 4 (72% vs 27%, P =. 010), and have higher mean weights at pretreatment and all posttreatment visits ( P <. 05). Mean weights at pretreatment and posttreatment 0‐6, 6‐12, 12‐18, and 18‐24 month follow‐up visits were 164 ± 40, 160 ± 40, 159 ± 39, 160 ± 38, and 154 ± 35 pounds, respectively, in p16‐negative patients, but were 194 ± 47, 171 ± 38, 172 ± 39, 174 ± 44, and 187 ± 53 pounds, respectively, in p16‐positive patients, which improved from 0‐6 to 18‐24 month visits. Conclusions: Although the traditional post‐treatment weight loss was still seen in p16‐negative patients, p16‐positive patients were able to gain weight during 24‐month post‐treatment follow‐up after the initial rapid posttreatment weight loss.