Post-Treatment HPV Surface Brushings and Risk of Relapse in Oropharyngeal Carcinoma.

Barbara Kofler,Jozsef Dudas,Daniel Dejaco,Dorothee Von Laer,Gerlig Widmann,Wegene Borena,Veronika Innerhofer,Herbert Riechelmann,Teresa B Steinbichler

doi:10.3390/cancers12051069

Barbara Kofler, Jozsef Dudas + Show 7 more

Open Access

https://doi.org/10.3390/cancers12051069

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Journal: Cancers	Publication Date: Apr 25, 2020
Citations: 8	License type: CC BY 4.0

Affiliation: Universität Innsbruck, Innsbruck Medical University

Abstract

Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is a distinct subtype of head and neck cancer. Here, we investigated how frequently brushing remained high-risk (hr)-HPV positive after treatment and whether patients with positive post-treatment brushings have a higher recurrence rate. Following the end of treatment of patients with initially hr-HPV positive OPSCC, surface brushings from the previous tumor site were performed and tested for hr-HPV DNA. Of 62 patients with initially hr-HPV DNA-positive OPSCC, seven patients remained hr-HPV-DNA positive at post-treatment follow-up. Of the seven hr-HPV-positive patients at follow-up, five had a tumor relapse or tumor progression, of whom three died. The majority of patients (55/62) was HPV-negative following treatment. All HPV-negative patients remained free of disease (p = 0.0007). In this study, all patients with recurrence were hr-HPV-positive with the same genotype as that before treatment. In patients who were hr-HPV negative after treatment, no recurrence was observed.

Highlights

85% of adults acquire a human papillomavirus (HPV) infection in their life.Most Human papillomavirus (HPV) infections are transient, asymptomatic, and eliminated by the immune system [1,2].HPV viral infection can persist latently in a subset of the population
The prevalence of cancer of the oropharynx due to high-risk HPV (hr-HPV) infection has increased, in North America and Europe [7]. It differs from HPV-negative head and neck squamous cell carcinoma (HNSCC) by its risk factor profile, clinical behavior, and molecular biology
We reported that surface brushings from oropharyngeal cancer reliably detect HPV-DNA

Summary

Introduction

85% of adults acquire a human papillomavirus (HPV) infection in their life.Most HPV infections are transient, asymptomatic, and eliminated by the immune system [1,2].HPV viral infection can persist latently in a subset of the population. Persistent hr-HPV infection is associated with cervical, anogenital and oropharyngeal cancers [4,5]. Hr-HPV positive oropharyngeal squamous cell carcinoma (OPSCC) is a distinct subtype of head and neck carcinoma. Risk factors that may prevent the natural clearance of oropharyngeal hr-HPV infection are genetic and lifestyle factors like smoking and alcohol consumption [6]. The prevalence of cancer of the oropharynx due to hr-HPV infection has increased, in North America and Europe [7]. It differs from HPV-negative head and neck squamous cell carcinoma (HNSCC) by its risk factor profile, clinical behavior, and molecular biology

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