title: Incidence of human papillomavirus-related oropharyngeal cancer and outcomes after chemoradiation in a population of heavy smokers.
abstract: BACKGROUND
  Incidence of human papillomavirus (HPV)-related oropharyngeal carcinomas is increasing worldwide. The purpose of this study was to report the incidence in our region, and to determine the influence of HPV status on survival among a heavy smoking population.
  
  
  METHODS
  p16 expression was analyzed in 102 patients with stage II to IV treated with chemoradiation. Overall survival (OS), locoregional control, and disease-free survival (DFS) were compared for HPV+ and HPV- status.
  
  
  RESULTS
  The majority of patients were smokers (86%). p16 positivity was found in 26.7%. Patients who were HPV+ were younger (56 vs 59 years old; p = .052). No differences were observed regarding tumor stage, sex, or smoking between HPV+ and HPV-. Three-year OS was 67.4% for patients who were HPV+ versus 49.7% for HPV- (hazard ratio [HR], 0.55; p = .095).
  
  
  CONCLUSIONS
  Incidence of HPV-related oropharyngeal carcinoma in Spain is similar to that reported in other European countries. In this sample of heavy smokers, we observed a nonsignificant trend for better outcomes in patients who were HPV+.
authors.affiliation: Departments of Radiation Oncology and Pathology, Instituto de Investigación Hospital de la Princesa, Madrid, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Cerezo
authors.forename: Consuelo
authors.initials: C
authors.lastname: López
authors.forename: Alejandro
authors.initials: A
authors.lastname: de la Torre
authors.forename: Dolores
authors.initials: D
authors.lastname: Suárez
authors.forename: Asunción
authors.initials: A
authors.lastname: Hervás
authors.forename: Ana
authors.initials: A
authors.lastname: Ruiz
authors.forename: Claudio
authors.initials: C
authors.lastname: Ballestín
authors.forename: Margarita
authors.initials: M
authors.lastname: Martín
authors.forename: Pilar
authors.initials: P
authors.lastname: Sandoval
mesh_terms: D000368:Aged; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy* / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013030:Spain / Q000453:epidemiology
keywords: chemoradiation; human papillomavirus; incidence; oropharyngeal cancer; smoking