Prognostic importance of DNA from human papillomavirus in patients with oral squamous cell carcinoma

Abstract

Background Survival of patients with oral squamous cell carcinoma (OSCC) is generally low, with the likelihood of locoregional recurrence or disease progression (LR/DP). Knowledge of prognostic factors for survival is key to achieving an understanding and increased survival. The present study aimed to identify prognostic factors for patients with OSCC, especially the presence of DNA from human papillomavirus (HPV). Material and Methods Retrospective cohort study including 119 patients with OSCC treated at the National Cancer Institute in Mexico City (2009-2013). Clinical information was obtained from patient records including LR/DP. Formalin-fixed, paraffin-embedded tissues were obtained and used for detecting DNA from different types of HPV. Potential prognostic factors for Overall Survival (OS) were analyzed using the Cox proportional hazards model. Results After model adjustment, factors associated with longer OS were a pre-treatment platelet count above 400,000/mm3 (HR=0.09, p =0.026) and response to primary treatment (HR=0.26, p =0.001). HPV DNA was present in 23 (19.3%) of the patients and importantly, type 16 found in 19 of them. Although survival of HPV-positive patients was longer, difference was not significant. However, among patients with LR/DP, HPV positivity was significantly associated with increased survival (HR=0.23, p =0.034). Importantly, survival was significantly different for HPV-positive patients with LR/DP > 6 months (HR=0.20, p =0.002), had higher absolute lymphocyte count at start of treatment (HR=0.50, p =0.028) or had local rescue treatment (HR=0.24, p =0.019). Conclusions Although HPV positivity was not associated with a longer OS of OSCC patients, a better prognosis was significantly associated with HPV positivity and recurring or progressing disease, particularly with HPV type 16. Key words: HPV, human papillomavirus, HPV-16, oral squamous cell carcinoma, oral cancer, survival, locoregional recurrence, disease progression.

HPV-Negative and HPV-Positive Oral Cancer Cells Stimulate the Polarization of Neutrophils towards Different Functional Phenotypes In Vitro

“…Within the HNSCC group, patients with HPV-related OPSCC generally show significantly better therapeutic response, progression-free survival, and overall survival [6,7] compared to HPV-unrelated OPSCC. Although the impact of HPV status on the development and clinical behavior of OSCC is controversial, some studies have reported improved survival [20] and a better prognosis when associated with HPV infection [8]. Viral etiology alone is insufficient to confer favorable behavior to HNSCC [21].…”

“…It is well known that HPV+ OPSCC cases have a better prognosis and response to treatment compared to those negative for the virus [6,7]. However, the relevance of HPV status in OSCC is less clear, and the information is controversial [8].…”

Impact of <i>TLR9 </i>and <i>TLR7</i> gene polymorphisms on prognosis and survival of patients with oral squamous cell carcinoma

“…However, the significance of HPV status for the survival of OSCC patients is still controversial. While high risk HPV positivity could be a good predictor of five-year survival rate of OSCC patients [8,9], another study found that HPV status had no impact on OSCC prognosis, except in patients with recurrent or progressive disease, where HPV positivity was significantly associated with improved survival compared to HPVnegative OSCC patients [10]. Emerging evidences confirm that genetic variations in immune-related signaling pathways in both tumor and immune cells play a key role in the immune landscape, and influence the antitumor immune response and tumor progression.…”