title: Nodal status is not a prognostic factor in patients with HPV-positive oral/oropharyngeal tumors.
abstract: OBJECTIVE
  The primary aim is to compare the prognostic parameters in patients with HPV-positive and HPV-negative tumors. The secondary aim is to compare the patterns of treatment failure between these groups.
  
  
  METHODS
  Analysis of prognostic factors in a group of 170 patients.
  
  
  RESULTS
  High-risk HPV DNA was detected in 98 cases, 72 tumors were HPV negative. Both the overall and disease-specific survival rates were better in HPV-positive patients. In patients with HPV-negative tumors, the prognostic factors in univariate analysis were pT and pN classification, tumor stage, number of positive nodes, and extracapsular spread. Stage, pT, higher pN, and number of nodes maintained statistical significance after adjustment. None of the studied prognostic factors was significant in the group of patients with HPV-positive tumors. There was a significant difference in the local--regional recurrence rates--37% in HPV-negative cases and 18% in HPV-positive cases.
  
  
  CONCLUSIONS
  The characteristics of the extent of the disease in general and of regional lymph node metastasis in particular are probably much less important in the prediction of the outcome of HPV-positive than of HPV-negative tumors. Improved survival of patients with HPV-positive tumors is due mostly to the difference in the local-regional failure rates.
authors.affiliation: First Faculty of Medicine, Department of Otolaryngology, Head and Neck Surgery, Charles University in Prague, Prague, Czech Republic. jan.klozar@lfmotol.cuni.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Klozar
authors.forename: Eva
authors.initials: E
authors.lastname: Koslabova
authors.forename: Vit
authors.initials: V
authors.lastname: Kratochvil
authors.forename: Martina
authors.initials: M
authors.lastname: Salakova
authors.forename: Ruth
authors.initials: R
authors.lastname: Tachezy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral; D005260:Female; D005500:Follow-Up Studies; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000821:virology; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D017211:Treatment Failure
chemical_list: D004279:DNA, Viral