title: The impact of HPV infection, smoking history, age and operability of the patient on disease-specific survival in a geographically defined cohort of patients with oropharyngeal squamous cell carcinoma.
abstract: CONCLUSIONS
  Patients with human papillomavirus (HPV)-positive tumours had better 5-year disease-specific survival (DSS) than HPV-negative patients. TNM score only predicted prognosis among HPV-negative patients. A previous history of smoking and age at diagnosis predicted DSS among HPV-positive patients whereas operability at diagnosis predicted DSS among both HPV-positive and HPV-negative patients.
  
  
  OBJECTIVE
  HPV is a risk factor for oropharyngeal squamous cell carcinoma (OPSCC). The extent to which smoking, age and operability could play a role in HPV-positive surgically treated head and neck SCCs has not been extensively addressed previously and this study aimed to evaluate these factors.
  
  
  METHODS
  We identified 232 patients with OPSCC, of which 186 from the tonsil or base of the tongue region were treated in the period 1992-2008 in Western Norway. The 5-year DSS was recorded. Details on smoking history and whether the lesion was operable or not, as well as clinical information, were obtained retrospectively from the hospital records.
  
  
  RESULTS
  TNM stage predicted survival only among HPV-negative patients. A previous smoking affected prognosis only among HPV-positive patients (relative risk (RR) = 2.5; confidence interval (CI) = 1.0-6.2; p = 0.05). Increasing age of the patient had a negative effect on survival in HPV-positive patients only, especially among the oldest quartile (RR = 4.4; CI = 2.0-9.0; p < 0.001). Whether the tumour was operable or not uniquely predicted DSS both among HPV-positive (RR = 0.34; CI = 0.13-0.93; p < 0.05) and HPV-negative (RR = 0.25; CI = 0.10-0.66; p < 0.01) patients with tonsil/base of the tongue SCC.
authors: Department of Otolaryngology/Head & Neck Surgery, Haukeland University Hospital.
authors: Borghild
authors: B
authors: Ljøkjel
authors: Hilde
authors: H
authors: Haave
authors: Stein
authors: S
authors: Lybak
authors: Helene H
authors: HH
authors: Aarstad
authors: Asa
authors: A
authors: Karlsdottir
authors: Olav K
authors: OK
authors: Vintermyr
authors: Hans Jørgen
authors: HJ
authors: Aarstad
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D009959:Oropharyngeal Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D030361:Papillomavirus Infections / Q000150:complications*; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*
keywords: Human papillomavirus; age at diagnosis; disease stage; head and neck squamous cell carcinoma