title: Human papilloma virus infection in head and neck cancer.
abstract: BACKGROUND
  The causal link between cervical cancer and human papilloma virus (HPV) is well known. It is now becoming clear that some types of squamous-cell carcinoma of the head and neck, particularly oropharyngeal carcinoma (OPC), are also linked to HPV infection. The development of vaccines against certain HPV genotypes has changed the management strategy for HPV-associated diseases of the uterine cervix. An analogous approach is now being considered for the prevention of HPV-associated diseases of the head and neck.
  
  
  METHODS
  We review pertinent articles retrieved by a selective search of the literature for phase II and III trials providing evidence about a possible effect of HPV status on the survival rates of patients with OPC. Seven trials fulfilled our search criteria: four phase III trials with retrospective HPV analysis and three phase II trials with retrospective and prospective HPV analysis.
  
  
  RESULTS
  Patients with HPV-positive OPC survive significantly longer than those with HPV-negative OPC. Tobacco smoking has been identified as a negative prognostic factor in patients with either HPV-negative or HPV-positive disease.
  
  
  CONCLUSIONS
  The established treatment strategy for OPC in patients with and without the traditional risk factors (tobacco and alcohol consumption) is now being reconsidered in the light of what we have learned about the role of HPV infection. Ongoing and projected clinical trials with risk-factor stratification may soon lead to changes in treatment. Further study is needed to answer the question whether HPV infection in the head and neck region is carcinogenic.
authors.affiliation: Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. tribius@uke.uni-hamburg.de
authors.forename: Silke
authors.initials: S
authors.lastname: Tribius
authors.forename: Markus
authors.initials: M
authors.lastname: Hoffmann
mesh_terms: D015984:Causality; D015897:Comorbidity; D019317:Evidence-Based Medicine; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D038622:Internationality; D030361:Papillomavirus Infections / Q000401:mortality* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000401:mortality*; D015995:Prevalence; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D053918:Papillomavirus Vaccines
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