Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 9, 2022
Date Accepted: Oct 18, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The prevalence and prognostic value of human papillomavirus status in hypopharyngeal carcinoma
ABSTRACT
Background:
The role of the HPV status of the hypopharyngeal squamous cell carcinoma (HSCC) patients remains controversial.
Objective:
To determine the prevalence, prognostic effect, and chemotherapy decision-making of human papillomavirus (HPV) status in locally advanced hypopharyngeal squamous cell carcinoma (HSCC) (stage III-IVB) receiving primary radiotherapy.
Methods:
Patients diagnosed with stage III-IVB HSCC between 2010 and 2016 were identified. HPV status, demographics, clinicopathological characteristics, treatment, and survival data were captured. Kaplan-Meier analysis and Multivariable Cox regression analysis were performed.
Results:
We identified 531 patients in this study and 142 (26.7%) patients with HPV-positive disease. No significant differences were observed between those with HPV-negative and HPV-positive diseases with regards to demographics, clinicopathological characteristics, and chemotherapy use. HPV-positive HSCC had better head and neck cancer-specific survival (HNCSS) (P=0.001) and overall survival (OS) (P<0.001) than those with HPV-negative tumors. Similar results were found using the multivariable Cox regression analyses. Sensitivity analyses showed that the receipt of chemotherapy was associated with significantly improving HNCSS (P<0.001) and OS (P<0.001) than those without chemotherapy in HPV-negative HSCC, while comparable HNCSS (P=0.590) and OS (P=0.116) were found between both treatment arms in HPV-positive HSCC.
Conclusions:
Approximately one-quarter of HSCC may be HPV-related, and HPV-positive HSCC is associated with improved survival outcomes. Furthermore, additional chemotherapy appears to be not related to a survival benefit in HPV-positive tumors who received primary radiotherapy.
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