Abstract
BackgroundHPV is important in a subset of HNSCC. Our meta-analysis determined the clinical characteristics of HPV-related HNSCC.MethodPubmed search terms "HPV" and "HNSCC" were used to identify 34 studies since 1980. We obtained pooled adjusted odds ratio (OR) or hazard ratio (HR) using random or fixed-effects model and compared OS depicted in forest plot.ResultsA total of 5681 patients were included. The prevalence of HPV+ tumors was 22%, with 86.7% of HPV16+ genotype. The OR for HNSCC in HPV16+ patients was 4.44 (95% CI = 2.87-6.02). HPV status was associated with p16 expression (adj OR = 3.00; 0.90-9.70), and HPV+ tumors were less likely to harbor p53 mutations (adj OR = 0.21; 0.04-0.38). The HR for death in HPV+ patients was 0.42 (0.27-0.57). HPV+ HNSCC also had a better response to therapy.ConclusionHPV+ HNSCC are established as a separate biologic entity. Prospective trials are needed to establish the optimal therapy for HPV+ HNSCC.
Highlights
Squamous cell carcinoma of the head and neck (HNSCC) has an estimated incidence of 35,310 new cases in 2008 in the United States, with an expected 7590 deaths due to these cancers
The odds ratio (OR) for head and neck squamous cell carcinoma (HNSCC) in HPV16+ patients was 4.44
We established a prevalence of human papillomavirus (HPV) among all head and neck squamous cell carcinoma (HNSCC) patients of 21.95%
Summary
Squamous cell carcinoma of the head and neck (HNSCC) has an estimated incidence of 35,310 new cases in 2008 in the United States, with an expected 7590 deaths due to these cancers. A similar rise in the incidence of tonsillar squamous cell carcinomas from 1970-2002 has been shown in Sweden and has been associated with presence of human papillomavirus (HPV)[3]. Recent emerging data indicates that HPV related HNSCC define a unique population of patients with distinct biology that likely should be treated separately from non-HPV related HNSCC[19]. The aims of this metaanalysis are to consolidate the available data, improve understanding of the biology of HPV related HNSCC, and thereby identify goals for future research and trial design in HNSCC. Our meta-analysis determined the clinical characteristics of HPVrelated HNSCC
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