Prognostic effects of HPV detected in head and neck cancers.

EM Smith PhD^a, JM Ritchie PhD^a, D Wang MS^a, E Hamsikova PhD^b, MD Vonka^b, TH Haugen PhD MD^c,d, LP Turek MD^c,d

^aCollege of Public Health, University of Iowa, Prague, Czech Republic, ^bInstitute of Hematology and Blood Transfusion, Prague, Czech Republic, ^cCollege of Medicine, ^dVA Medical Center, Iowa City, IA, United States

AIM. To determine whether HPV status is associated with survival and recurrence of had and neck cancer (HNC) METHODS. HNC cases with a newly diagnosed oral cavity or oropharyngeal cancer were evaluated for HPV status and type in tumor tissue and oral exfoliated cells using PCR, DNA dot blot hybridization, and DNA sequencing. The presence of anti-VLP antibodies in sera from HNC cases using HPV-HR type specific ELISA assays for seropositivity. RESULTS. Among 136 newly diagnosed HPC cases with biopsy HPV results, 21% were detected with HPV-HR infection. Adjusting for age, gender, tumor grade, stage of disease, treatment modality, tobacco, alcohol, and tumor histology, patients detected with HPV-HR in tumors had better prognosis than HPV-negative patients for overall survival (hazard ratio (HR)=0.4; 95% CI:0.2-0.9) and disease-specific survival (HR=0.5,0.2-1.1). There was a larger difference in disease-specific survival between biopsy HPV-HR and HPV-negative patients with advanced stage (III/IV) of disease who received combined surgery/radiation (HR=0.3, p=0.09). Advanced stage patients receiving surgery/radiation showed a difference in 2-year recurrence rates between HPV-HR vs. HPV-negative patients (HR=0.3, p=0.12). Patients with HPV-HR in oral exfoliated cells also had significantly better prognosis and less disease recurrence than HPV-negative patients, (2-year overall survival: HR=0.5, p=0.004; disease-specific survival: HR=0.5, p=0.03; recurrence: HR=0.5, p=0.03). Serologic assessment also showed significantly better survival for the HPV-HR cases vs. HPV-negative patients, with (HR=0.4, p=0.04; disease-specific survival: HR=0.3, p=0.01). CONCLUSIONS. Findings suggest that survival is better and recurrence is less in HPV-positive HNC cases and use of oral exfoliated cells or sera may predict HPV-HR in tumors, and survival and recurrence.

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Nice, France; February 7 - 10, 2004; in oral session 791 (Viral Infections).