Human papillomavirus genotype and oropharynx cancer survival in the United States of America

• Largest study was conducted regarding an association of human papillomavirus (HPV) status with oropharyngeal squamous cell cancer (OPSCC) prognosis.
• Survival was significantly longer for HPV+ compared with HPV– OPSCC patients.
• Five-year survival for HPV16+ OPSCC was higher compared to other high-risk HPV types.
• The 2.6-fold greater risk of death among Blacks compared with non-Hispanic Whites with OPSCC persisted after adjustment for HPV status.

BackgroundThe presence of human papillomavirus (HPV) DNA in oropharyngeal squamous cell cancer (OPSCC) tissue appears to be a strong predictor of improved prognosis, but this observation has not been explored in a population-based sample with generalisable findings.MethodsFollow-up data from a large sample of OPSCC patients identified through six population-based cancer registries in the United States of America (USA) were used to characterise the association of tumour HPV status with survival.ResultsHPV DNA was detected in tumour tissue from 71% (378 in 529) of the OPSCC patients. A total of 65% of patients with HPV16-associated tumours survived 5 years compared to 46% of patients with other HPV types and 28% of patients with HPV-negative tumours (p log-rank test <0.0001). The OPSCC patients with detectable HPV16 DNA had a 62% reduced hazard of death at 5 years, and patients with other HPV types had a 42% reduced hazard of death at 5 years compared to HPV-negative patients. Compared to non-Hispanic Whites, Blacks with OPSCC had a 2.6-fold greater risk of death at 5 years after adjustment for HPV status and other prognostic variables. Both surgery and radiation therapy were associated with a reduced 5-year risk of death, but no evidence was found for an interaction between HPV status and radiotherapy or surgery on survival time.ConclusionsData from this US study suggest that HPV16-positive OPSCC patients survive longer than HPV-negative patients regardless of treatment, highlighting the prognostic importance of HPV status for this malignancy. Optimal treatment regimens for OPSCC could be tailored to each patient’s HPV status and prognostic profile.