Human papilloma virus in patients with epidermoid head and neck carcinoma: a prognostic factor?
BACKGROUND
The three most important prognostic factors in patients with head and neck squamous cell carcinoma (HNSCC) are tumor size, nodular histological condition and tumor origin. Recently, human papilloma virus (HPV), particularly HPV-16, has been acknowledged as a prognostic factor. HPV+ patients have better survival than HPV-. This has created a controversy because other factors may influence the prognosis. The objective of this study was to investigate whether HPV has prognostic value in patients with HNSCC.


METHODS
We carried out a retrospective evaluation of patients with HNSCC and the following variables were analyzed: survival, tumor location, stage, general condition according to Eastern Cooperative Oncology Group (ECOG) status, treatment and HPV association identified by PCR. We used a descriptive analysis of simple frequencies and central tendency and dispersion measures according to the type of variables. We used descriptive analysis for overall survival with Kaplan- Meier and Cox regression with 95% confidence interval.


RESULTS
There were 179 patients included: 119 (66.5%) were male. Average age of patients was 64 years; 34% of the tumors were located in the oral cavity and 33% were located in the larynx. Factors associated with survival were ECOG (RR = 11.3; 2.6-48), clinical stage (RR = 7.8; 1.7-34), age >70 years (RR = 3.5, 1.4-8.5) and nonsurgical treatment (RR = 2.3; 1.4-3.8). Average overall survival for patients with HPV16 was 22 months vs. 28 months in those with other types of viruses. HPV infection was not associated with the prognosis in this series.


CONCLUSIONS
ECOG at the time of the diagnosis and clinical stage were the most significant prognostic factors in this series. HPV did not show any prognostic value.
Flores-de la Torre
Celia
C
Departamento de Oncología Médica, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D. F., Mexico.
Hernández-Hernández
Dulce María
DM
Gallegos-Hernández
José Francisco
JF
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000821:virology*; D015344:DNA Probes, HPV; D005260:Female; D006258:Head and Neck Neoplasms / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D011379:Prognosis; D012189:Retrospective Studies
D015344:DNA Probes, HPV