title: Pathologic Markers in Surgically Treated HPV-Associated Oropharyngeal Cancer: Retrospective Study, Systematic Review, and Meta-analysis.
abstract: OBJECTIVE
  Human papillomavirus-associated (HPV) oropharyngeal cancer is a unique clinical entity whose incidence is increasing. It is controversial whether traditional pathologic markers of aggressive head and neck cancer also apply in surgically treated HPV-associated disease.
  
  
  METHODS
  Retrospective study, systematic review, and meta-analysis Data Sources: PubMed and Cochrane review.
  
  
  METHODS
  PubMed and Cochrane review were searched for published articles on surgically treated HPV-associated oropharyngeal cancer. Eligible studies were included in a meta-analysis of survival using several clinicopathologic markers as predictors. Surgically treated HPV-positive oropharyngeal cancer patients at our institution were studied retrospectively and added to the meta-analysis.
  
  
  RESULTS
  Eight published reports, plus our retrospective series, were included in the meta-analysis. This showed significant impact on event-free survival for T stage, nodal number, perineural invasion, and lymphovascular invasion (all P < .05) but not for N stage extracapsular extension ( P = ns).
  
  
  CONCLUSIONS
  While many traditional clinico-pathologic markers of aggressive disease in head and neck cancer also impact survival in surgically treated HPV-associated oropharyngeal cancer, extracapsular extension may be less important.
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tassone
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Crawley
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Cory
authors.initials: C
authors.lastname: Bovenzi
authors.affiliation: 2 Department of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Tingting
authors.initials: T
authors.lastname: Zhan
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: William
authors.initials: W
authors.lastname: Keane
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: David
authors.initials: D
authors.lastname: Cognetti
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Luginbuhl
authors.affiliation: 1 Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Curry
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies
keywords: HPV; human papillomavirus; oropharyngeal cancer; pathologic markers