Survival of patients with oropharyngeal cancer associated with positive HPV status

January 01, 0001

Survival of patients with oropharyngeal cancer associated with positive HPV status

These US authors performed a retrospective analysis of the association between tumor HPV status and survival among patients with stage III or IV oropharyngeal squamous-cell carcinoma who were enrolled in a randomized trial comparing accelerated-fractionation radiotherapy (with acceleration by means of concomitant boost radiotherapy) with standard- fractionation radiotherapy, each combined with cisplatin therapy, in patients with squamous-cell carcinoma of the head and neck.

They found: "The median follow-up period was 4.8 years. The 3-year rate of overall survival was similar in the group receiving accelerated- fractionation radiotherapy and the group receiving standard- fractionation radiotherapy (70.3% vs. 64.3%, NS), as were the rates of high-grade acute and late toxic events. A total of 63.8% of patients with oropharyngeal cancer (206 of 323) had HPV-positive tumors; these patients had better 3-year rates of overall survival (82.4%, vs. 57.1% among patients with HPV-negative tumors) and, after adjustment for age, race, tumor and nodal stage, tobacco exposure, and treatment assignment, had a 58% reduction in the risk of death (hazard ratio, 0.42). The risk of death significantly increased with each additional pack-year of tobacco smoking. Using recursive-partitioning analysis, we classified our patients as having a low, intermediate, or high risk of death on the basis of four factors: HPV status, pack-years of tobacco smoking, tumor stage, and nodal stage."

The authors concluded: "Tumor HPV status is a strong and independent prognostic factor for survival among patients with oropharyngeal cancer."

Testing for HPV status or oropharyngeal cancers is likely to become standard practice.

For the full abstract, click here.

N Engl J Med 363:24-35, 1 July 2010
© 2010 to the Massachusetts Medical Society
Human Papillomavirus and Survival of Patients with Oropharyngeal Cancer. K. Kian Ang, Jonathan Harris, Richard Wheeler, et al. Correspondence to Dr. Gillison: [email protected]

Category: D. Digestive. Keywords: oropharyngeal cancer, squamous-cell carcinoma human pappilomavirus, HPV, prognosis, retrospective cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 20 July 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.