title: HPV-16 infection modifies overall survival of Puerto Rican HNSCC patients.
abstract: BACKGROUND
  HPV-16 modifies the overall survival (OS) of patients with oropharyngeal cancer (OPSCC). HPV-16 has been established as risk factor for OPSCC, but HPV-16 infection may also reside in the larynx and oral cavity. We evaluated HPV-16 status on OS of Head and Neck Squamous Cell Carcinoma (HNSCC) patients.
  
  
  METHODS
  HPV-16 infection was confirmed by amplification of E6 and E7 viral oncogenes through PCR assay and E6 IHC in 185 HNSCC samples. Associations between HPV-16 status and clinicopathological parameters were performed using Fisher's exact test and x(2). Survival analysis was completed using Kaplan-Meier estimator and multivariate Cox regression analysis.
  
  
  RESULTS
  OS of HPV-16 positive patients was longer compared to HPV-16 negative patients (P = 0.002). HPV-16 positive tumors of the larynx (LSCC) and pharynx (PSCC) showed improved OS compared to HPV-16 negative tumors. Also, HPV-16 positive patients exposed to radiotherapy presented a better survival.
  
  
  CONCLUSIONS
  HPV-16 status has a positive prognostic value in HNSCC. Addition of HPV-16 status to the TNM staging can provide better assessment in prognosis and guide treatment for HNSCC patients.
authors: Department of Biology, Natural Sciences Faculty, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico.
authors: Bianca
authors: 0000-0001-8821-0210
authors: B
authors: Rivera-Peña
authors: Department of Otolaryngology, Head and Neck Surgery Section, University of Puerto Rico, School of Medicine, PO Box 365067, San Juan, 00936 Puerto Rico.
authors: Francisco J
authors: FJ
authors: Ruíz-Fullana
authors: Department of Biology, Natural Sciences Faculty, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico.
authors: Germán L
authors: GL
authors: Vélez-Reyes
authors: Department of General Social Sciences, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico.
authors: Rosa J
authors: RJ
authors: Rodriguez-Benitez
authors: Department of Pathology and Laboratory Medicine, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico.|Medical Services Administration, San Juan, Puerto Rico.
authors: María J
authors: MJ
authors: Marcos-Martínez
authors: Department of Otolaryngology, Head and Neck Surgery Section, University of Puerto Rico, School of Medicine, PO Box 365067, San Juan, 00936 Puerto Rico.
authors: Juan
authors: J
authors: Trinidad-Pinedo
authors: Department of Otolaryngology, Head and Neck Surgery Section, University of Puerto Rico, School of Medicine, PO Box 365067, San Juan, 00936 Puerto Rico.|Department of Pharmacology and Toxicology, University of Puerto Rico, School of Medicine, San Juan, Puerto Rico.
authors: Adriana
authors: A
authors: Báez
keywords: Biomarker; Head and neck squamous cell carcinoma; Human Papillomavirus (HPV); Overall Survival (OS); TNM