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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).

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

Conclusion 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.



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Issue
The Journal of Community and Supportive Oncology - 14(5)
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Page Number
215-220
Legacy Keywords
QUAD SHOT, chemotherapy, pain control, radiation, cyclical hypofractionated radiotherapy
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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).

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

Conclusion 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.



Click on the PDF icon at the top of this introduction to read the full article.

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).

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

Conclusion 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.



Click on the PDF icon at the top of this introduction to read the full article.

Issue
The Journal of Community and Supportive Oncology - 14(5)
Issue
The Journal of Community and Supportive Oncology - 14(5)
Page Number
215-220
Page Number
215-220
Publications
Publications
Topics
Article Type
Display Headline
Prognostic significance of HPV status in postoperative squamous-cell carcinoma of the head and neck
Display Headline
Prognostic significance of HPV status in postoperative squamous-cell carcinoma of the head and neck
Legacy Keywords
QUAD SHOT, chemotherapy, pain control, radiation, cyclical hypofractionated radiotherapy
Legacy Keywords
QUAD SHOT, chemotherapy, pain control, radiation, cyclical hypofractionated radiotherapy
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JCSO 2016;14:215-220
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