title: Quality of life in head and neck cancer patients: impact of HPV and primary treatment modality.
abstract: OBJECTIVE
  To determine posttreatment quality of life (QOL) in head and neck cancer patients, stratifying by human papillomavirus (HPV)/p16 status and primary treatment modality.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  One hundred and seventy-seven patients (N=177) with head and neck squamous cell carcinoma and known HPV/p16 status were included. All patients completed at least one baseline or posttreatment University of Washington QOL survey. QOL scores were averaged and compared across patients, stratifying by HPV/p16 status and primary treatment modality (surgical vs. nonsurgical). In the analysis, p16 was used as a surrogate marker for HPV.
  
  
  RESULTS
  Of the 177 patients, 80 (45.2%) were p16-positive and 49.7% of subsites were oropharyngeal. Nearly 60% (105/177) of patients underwent primary surgery, 26.7% (28/105) of patients with transoral robotic or laser techniques. The remainder 40.7% of patients underwent primary radiation and/or chemotherapy. Overall, QOL scores were better for p16-positive patients compared to p16-negative patients at baseline (P=0.008), at 6 months posttreatment (P=0.034), and at greater than 1 year posttreatment (P=0.013). P16-positive patients had better QOL scores in speech (P=0.0009), chewing (P=0.0004), and swallowing (P=0.021) after 1 year posttreatment compared to p16-negative patients. Primary treatment modality did not affect overall QOL or any of the 12 QOL categories in p16-positive patients at any time point. At over 1 year posttreatment, QOL was at or above baseline in both p16-positive treatment groups.
  
  
  CONCLUSIONS
  The p16-positive patients had better baseline and posttreatment overall QOL compared to p16-negative patients. The overall and category specific QOL scores for p16-positive patients were not affected by primary treatment modality.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Maxwell
authors.forename: Vikas
authors.initials: V
authors.lastname: Mehta
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.forename: Diana
authors.initials: D
authors.lastname: Cunningham
authors.forename: Umamaheswar
authors.initials: U
authors.lastname: Duvvuri
authors.forename: Seungwon
authors.initials: S
authors.lastname: Kim
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
mesh_terms: D052685:Alphapapillomavirus / Q000235:genetics*; D002294:Carcinoma, Squamous Cell / Q000523:psychology* / Q000628:therapy / Q000821:virology; D003131:Combined Modality Therapy; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D019942:Genes, p16; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000628:therapy / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000523:psychology* / Q000628:therapy / Q000821:virology; D011788:Quality of Life; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D011795:Surveys and Questionnaires
chemical_list: D004279:DNA, Viral
keywords: HPV; Quality of life; head and neck squamous cell carcinoma; p16