Characteristics and prognostic implications of high-risk HPV-associated hypopharyngeal cancers.
BACKGROUND
High-risk human papillomavirus (HPV) is an oncogenic virus that causes oropharyngeal cancers, and it has a favorable outcome after the treatment. Unlike in oropharyngeal cancer, the prevalence and role of high-risk HPV in the etiology of hypopharyngeal squamous cell carcinoma (HPSCC) is uncertain.


OBJECTIVE
The aim of the present study was to evaluate the effect and prognostic significance of high-risk HPV in patients with HPSCC.


METHODS
The study included 64 subjects with HPSCC who underwent radical surgery with or without radiation-based adjuvant therapy. Primary tumor sites were the pyriform sinus in 42 patients, posterior pharyngeal wall in 19 patients, and postcricoid area in 3 patients. High-risk HPV in situ hybridization was performed to detect HPV infection.


RESULTS
The positive rate of high-risk HPV in situ hybridization was 10.9% (7/64). There was a significant difference in the fraction of positive high-risk HPV among pyriform sinus cancer (16.7%), posterior pharyngeal wall cancer (0%), and postcricoid area cancer (0%) (p = 0.042). The laryngoscopic examination revealed a granulomatous and exophytic appearance in 85.7% (6/7) of patients with high-risk HPV-positive pyriform sinus cancer, but in only 31.4% (11/35) of patients with high-risk HPV-negative pyriform sinus cancer (p = 0.012). Significant correlations were found between positive high-risk HPV and younger age (p = 0.050) and non-smoking status (p = 0.017). HPV-positive patients had a significantly better disease-free survival (p = 0.026) and disease-specific survival (p = 0.047) than HPV-negative patients.


CONCLUSIONS
High-risk HPV infection is significantly related to pyriform sinus cancer in patients with HPSCC.
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Young-Hoon
YH
Joo
Youn-Soo
YS
Lee
Kwang-Jae
KJ
Cho
Jun-Ook
JO
Park
In-Chul
IC
Nam
Chung-Soo
CS
Kim
Sang-Yeon
SY
Kim
Min-Sik
MS
Kim
D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology; D012307:Risk Factors; D015996:Survival Rate