Prognostic significance of HPV status in postoperative squamous-cell carcinoma of the head and neck.
BACKGROUND
There are limited data on the prognostic significance of human papillomavirus (HPV) status in relation to traditional risk factors for head and neck squamous-cell carcinoma (HNSCC) in the postoperative setting.


OBJECTIVE
To clarify the impact of HPV status on the risk for HNSCC in the postoperative setting.


METHODS
We retrospectively evaluated an institutional cohort of 128 patients with HNSCC patients who had been treated with definitive surgery with or without adjuvant radiotherapy or chemoradiotherapy. Patient, disease, and treatment factors were analyzed as potential prognostic indicators.


RESULTS
Lymph node extracapsular extension (ECE), perineural invasion (PNI), and lymphovascular space invasion (LVSI) positivity predicted poorer locoregional control (LRC), disease-free survival (DFS), and overall survival (OS). Positive margins related to poorer DFS and OS. HPV status alone did not predict LRC, DFS, or OS. Compared with patients who were HPV-positive and ECE-negative, both HPV-positive and HPV-negative patients with ECE experienced significantly poorer OS (78.6%, 60%, and 43.7%, respectively; 𝑃 = .010 and 𝑃 = .018, respectively).


CONCLUSIONS
Retrospective, single-institution study; small patient cohort; short follow-up time.


CONCLUSIONS
The influence of HPV in postoperative HNSCC seems limited compared with traditional risk factors such as ECE, LVSI, and PNI. De-escalation of postoperative treatment based on HPV status alone should be approached with caution.
Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Matthew H
MH
Bertke
Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Joseph N
JN
Shaughnessy
Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Matthew K
MK
Forsthoefel
Department of Otolaryngology-HNS & Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Liz D
LD
Cash
Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Craig L
CL
Silverman
Department of Otolaryngology-HNS & Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Jeffrey M
JM
Bumpous
Department of Otolaryngology-HNS & Communicative Disorders, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Kevin L
KL
Potts
Department of Medical Oncology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Rebecca A
RA
Redman
Department of Medical Oncology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Cesar A
CA
Perez
Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, Kentucky. Nedunl01@louisville.edu.
Neal E
NE
Dunlap
ECE; HPV; LVSI; PNI; extracapsular extension; head and neck cancer; human papillomavirus; lymphovascular space invasion; perineural invasion