Human papillomavirus in laryngeal and hypopharyngeal carcinomas. Relationship to survival.
OBJECTIVE
To determine the relationship between human papillomavirus (HPV) DNA detection in upper aerodigestive tract malignancies and patient outcome.


METHODS
Archival paraffin-embedded specimens from 78 previously untreated patients with squamous carcinomas of the larynx and hypopharynx were pathologically verified and analyzed by polymerase chain reaction for detection of HPV DNA. Charts were independently reviewed and coded until final analysis.


METHODS
The University of Texas M. D. Anderson Cancer Center, Houston, a tertiary cancer referral center.


RESULTS
DNA was successfully extracted from 65 archival patient samples (83%). The mean (+/- SEM) duration of follow-up for these patients was 42 +/- 21 months. Thirty specimens (46%) exhibited detectable HPV DNA. Detection of HPV was significantly related to decreased survival, independent of disease stage. Log rank testing revealed that HPV detection, pathologic vascular invasion, and nodal status were the most significant predictors of death of disease.


CONCLUSIONS
Laryngeal and hypopharyngeal carcinomas with detectable HPV may represent a biologically distinct subset of tumors that carry a poorer prognosis than do cancers with no detectable HPV.
Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston.
G L
GL
Clayman
M G
MG
Stewart
R S
RS
Weber
A K
AK
el-Naggar
E A
EA
Grimm
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology* / Q000821:virology*; D007013:Hypopharynx; D015994:Incidence; D007818:Laryngeal Diseases / Q000150:complications* / Q000175:diagnosis; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications* / Q000175:diagnosis; D010608:Pharyngeal Diseases / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D014412:Tumor Virus Infections / Q000150:complications* / Q000175:diagnosis
D004279:DNA, Viral