Abstract
Purpose To determine the prevalence and clinical significance of human papillomavirus (HPV) in a large, consecutive cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) and to develop a prognostic model for patients with OPSCC. Patients and methods All patients diagnosed with OPSCC between 2000 and 2006 in two main university hospitals in the Netherlands were included ( n = 841). The presence of an oncogenic HPV infection was determined by immunostaining for p16 INK 4 A , followed by a high-risk HPV GP5+/6+ DNA PCR on the p16 INK 4 A immuno-positive cases. Cox regression analysis was performed to compare survival rates between HPV-positive and HPV-negative patients and a prognostic model was generated by recursive partitioning. Results In total, 163 of 841 (19.4%) patients were p16 and HPV DNA-positive. HPV-positive patients had a more favorable overall survival (73.5% vs. 40.9% after 5 years; p Conclusions Tumor HPV status is a strong and independent prognostic factor for survival among patients with OPSCC. The existing prognostic model (1) for OPSCC patients was validated. An additional model was proposed, based on our large, unselected cohort of OPSCC patients. In this model, HPV-status, comorbidity and nodal stage were the important prognostic factors.
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