HPV+ Oral Cancer Patients Do Not Have Better QOL Trajectory

Abstract

Objective: To determine the role of human papillomavirus (HPV) status on quality of life (QOL) in patients with oral cavity and oropharyngeal squamous cell carcinoma (OSCC). We hypothesized that high risk HPV (HPV-16, 18, 35, 45) tumors would be associated with better QOL trajectory. Method: Head and neck-specific QOL was determined using the University of Washington Quality of Life (UW-QOL) scale version 4 in patients with newly diagnosed invasive OSSC (n = 296). Results: Pre-treatment QOL was higher in patients with high risk HPV tumors compared with patients with HPV negative or low risk HPV (HPV-11, 32, 53, 66) tumors ( P = .004). This association remained in multivariate analysis. Patients with high risk HPV tumors had larger decreases in QOL from pre-treatment to immediate posttreatment compared with patients with HPV negative or low risk HPV tumors ( P = .032). There was no association between HPV status and QOL 1 year posttreatment. Conclusion: Among patients with OSCC, high risk HPV was independently associated with higher pretreatment QOL. The data did not support our hypothesis that patients whose tumors contain high risk HPV have better QOL trajectory. Research exploring patient expectations, treatment effects, and psychiatric comorbidity may provide insight into this finding.