Assessment of HPV16 infection in patients with laryngeal cancer.

Abstract

The purpose ofthestudy was to investigate HPV16 infection in laryngeal cancer patients treated with surgery and adjuvant radiotherapy as well as to analyze treatment results in relation to HPV16 infection and selected clinical, histopathological, and radiotherapy parameters. A retrospective analysis was performed in agroup of60 patients with squamous cell carcinoma ofthelarynx treated surgically and qualified for adjuvant radiotherapy at theOncology Center in Cracow between 1995 and 2001. Thestudied group consisted of57 men (95%) and 3 women (5%) ofmean age of56 years. In 13 patients (22%) underweight was noted. In theanalyzed material, locally advanced laryngeal cancer prevailed (pT3-pT4) - 52 cases (87%), with theinvolvement ofcervical lymph nodes (pN+) - 32 cases (53%). Histopathological examination revealed that microscopic radicality was not obtained in 18 patients (30%). Human papillomavirus 16 infection status as well as infection type (integrated, episomal, or mixed) were assessed in each patient by means ofquantitative polymerase chain reaction (qPCR) using real-time detection. The 5-year OS, DFS, and LC rates were 45%, 61%, and 69%, respectively. Multivariate analysis revealed that local relapse risk and local failure risk were statistically significantly influenced by underweight and positive surgical margin. Underweight had also astatistically significant impact on death risk. TheHPV16 infection was noticed in 4 cancers (6.8%). In all cases it was thesame episomal type. On thebasis ofour observations it can be assumed that HPV infection does not play animportant role in etiology oflaryngeal cancer. Although, further study is needed in larger patient populations; optimal methodology for detecting HPV infection should also be determined. Positive surgical margin has asignificant effect on worse treatment outcomes. Underweight before radiotherapy diminishes theprobability oftreatment success and survival oflaryngeal cancer patients.