Abstract
PurposeRecently, p16 has been included in the TNM guideline for oropharyngeal carcinomas. The role of HPV and p16 in hypopharyngeal and laryngeal carcinomas has not yet been established sufficiently.MethodsHundred and thirty-four patients with hypopharyngeal and laryngeal carcinomas were included in this retrospective analysis. Only patients with known HPV status were eligible for the investigation. Survival probabilities were estimated for different risk factors.ResultsEighty-five patients presented with laryngeal carcinoma and 49 patients with hypopharyngeal carcinoma. 8% were HPV positive (10.6% laryngeal, 4.1% hypopharyngeal carcinoma). Median follow-up time was 58 months. We observed a significantly better overall survival for patients with an early tumor stage compared to advanced carcinoma. One of the hypopharyngeal HPV positive carcinomas was also p16 positive and one was p16 negative. Of the nine HPV positive laryngeal carcinomas, four were p16 positive and five p16 negative. Neither patients who were HPV positive nor patients positive for p16 showed a significantly better outcome than HPV or p16 negative patients. In contrast, nicotine pack-years showed a highly significant correlation with survival in our patient collective.ConclusionsThe data suggest that tumor stage and nicotine exposure seem to have the highest impact on survival in hypopharyngeal and laryngeal squamous cell carcinoma patients. There is no evidence for a better survival for p16 positive or HPV positive patients with hypopharyngeal or laryngeal squamous cell carcinoma. HPV seems to play a minor role in these entities of head and neck carcinoma.
Highlights
More than 30 years ago, a link between human papillomavirus (HPV) and head and neck cancer (HNC) was found
Tobacco and alcohol have been the most important risk factors for the development of head and neck carcinomas for the past decades. After studies including those of Fahkry et al, which could demonstrate that patients with HPV positive oropharyngeal carcinomas have at least half the risk of death than HPV negative patients [5], HPV has recently been acknowledged as a risk factor for oropharyngeal carcinoma by the International Agency for research on Cancer
The data presented suggest that tumour stage and nicotine exposure seem to have the highest impact on survival in hypopharyngeal and laryngeal squamous cell carcinoma patients
Summary
More than 30 years ago, a link between human papillomavirus (HPV) and head and neck cancer (HNC) was found. Since numerous studies have been performed on this topic and showed a better prognosis for HPV positive oropharyngeal squamous cell carcinomas (OPSCC) than for HPV negative OPSCCs. Since numerous studies have been performed on this topic and showed a better prognosis for HPV positive oropharyngeal squamous cell carcinomas (OPSCC) than for HPV negative OPSCCs This fact is underlined by the inclusion of p16 in the updated TNM classification [1]. The role of p16 and HPV in non-oropharyngeal squamous cell carcinomas has not yet been established sufficiently, varying results have been presented. The aim of this study was to evaluate patients with HPV and/or p16 positive and negative hypopharyngeal and laryngeal squamous cell carcinomas and compare overall survival. Overall survival for traditional risk factors and tumour stage was reviewed
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