title: Increased viral load correlates with improved survival in HPV-16-associated tonsil carcinoma patients.
abstract: CONCLUSIONS
  Our results indicate that viral load may serve as an independent prognostic indicator for patients with HPV-16-associated squamous cell carcinoma of the tonsil.
  
  
  OBJECTIVE
  HPV-16 has gained increasing attention as a possible causative agent for squamous cell carcinoma of the tonsil. Recent reports have indicated that the viral load within the tumor, along with other factors, may be correlated to the patient survival. In this study, we sought to examine HPV-16 viral load as an independent prognostic indicator.
  
  
  METHODS
  DNA was extracted from 35 tonsil carcinoma samples and the viral load was determined by real-time PCR. The patients were divided into four groups according to HPV-16 viral load. The correlation between viral load and recurrence, disease-free survival, and overall survival was assessed.
  
  
  RESULTS
  We found that HPV-positive patients with the highest viral loads had improved overall and disease-free survival. Recurrences of squamous cell carcinoma were significantly less likely to occur with increasing viral load.
authors.affiliation: Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Cohen
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Basha
authors.forename: Dawn K
authors.initials: DK
authors.lastname: Reichenbach
authors.forename: Erle
authors.initials: E
authors.lastname: Robertson
authors.forename: Duane A
authors.initials: DA
authors.lastname: Sewell
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000821:virology*; D018572:Disease-Free Survival; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000821:virology; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000401:mortality / Q000473:pathology / Q000821:virology*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology / Q000821:virology*; D019562:Viral Load