Systematic review on location and timing of distant progression in human papillomavirus‐positive and human papillomavirus‐negative oropharyngeal squamous cell carcinomas

Tiedemann, Daniel; Jakobsen, Kathrine Kronberg; Buchwald, Christian von

doi:10.1002/hed.25458

Cited by 16 publications

(18 citation statements)

References 28 publications

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“…Further, patients who are positive for both HPV-DNA and p16 (HPV-DNAþ/p16þ) have shown a significantly better overall survival rate compared to HPV-DNA-/p16þ, or HPV-DNAþ/p16-patients, who may be considered HPV-positive in studies using either HPV-DNA or p16 status solely when defining HPV-status [12]. Referring to a recent systematic review, the risk of distant progression was lower in HPV-positive patients compared to HPV-negative patients [13]. The rate of locoregional recurrences in the two groups has not yet been fully explored.…”

Section: Introductionmentioning

confidence: 99%

Rate of locoregional recurrence among patients with oropharyngeal squamous cell carcinoma with known HPV status: a systematic review

et al. 2020

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Background: We aimed to review systematically the literature on locoregional recurrence rates in patients with HPV-positive and-negative oropharyngeal squamous cell carcinoma (OPSCC). Methods: PubMed and Embase databases were systematically searched using key words such as human papillomavirus, oropharyngeal squamous cell carcinoma with local, regional, and locoregional recurrence. Results: Nine studies (2974 patients with known HPV-status, 59% HPV-positive) were included. Among the HPV-positive and-negative patients, 69% and 58% had lymph node metastasis at diagnosis. At a median time to recurrence ranging from 8.4 to 13.2 months among the included studies, we found that a weighted average of 9% and 26% for HPV-positive and-negative patients experienced locoregional recurrence. Overall, the median follow-up time ranged from 21 to 83 months among the included studies. Conclusion: Recurrence rates for HPV-positive and-negative OPSCC patients were 9% and 26%, respectively, equating to an almost three times higher rate of locoregional recurrence among HPVnegative patients compared to HPV-positive patients.

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Section: Introductionmentioning

confidence: 99%

Rate of locoregional recurrence among patients with oropharyngeal squamous cell carcinoma with known HPV status: a systematic review

et al. 2020

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“…Previous studies from this group have attempted to assess the prevalence of HPV infection among the adult and pediatric clinic populations [15][16][17]. These studies appeared to support evidence that has suggested the incidence of oral HPV infection in the United States may, in fact, be increasing [8,9,11]. However, other recent studies of microbial prevalence have recently increased the potential pool of oral samples available for further HPV screening and analysis [18,19].…”

Section: Introductionmentioning

confidence: 94%

“…In fact, HPV infection has been identified as a clinically significant biomarker and prognostic indicator for oral squamous cell carcinomas [9][10][11]. These studies suggest that oral infection with high-risk HPV may significantly increase the risk of developing oral cancers, as well as limiting the long-term prognosis for these patients [10,11].…”

Section: Introductionmentioning

confidence: 99%

Screening for Oral High-risk Human Papillomavirus (HPV) among a Pediatric Patient Population

Bowen¹,

Kingsley²

2019

JAMMR

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Introduction: Human papillomavirus (HPV) is a known cancer-causing virus that has been primarily linked to cervical cancers. Recent studies have shown that HPV may also induce cancer in other tissues, including oral epithelia and mucosa. To determine the presence of oral HPV infection among pediatric patients, salivary samples were assessed to determine oral prevalence of high-risk HPV. Methods: Using existing pediatric saliva samples from pediatric clinic patients (aged 6 -16 years), this retrospective study involved isolating DNA for PCR screening for both high-risk strains of HPV (HPV16, HPV18). A total of n=98 patient samples were available for analysis. Results: Demographic analysis of these samples revealed the majority were derived from females (63.2%) and mostly from Hispanics (54.1%). DNA was successfully isolated from 95.9% of samples (n=94/98) with an average concentration of 142.5 ng/uL. PCR screening demonstrated only a subset of patient samples harbored high-risk strains, HPV16 (n=9) and HPV18 (n=6), which Bowen and Kingsley; JAMMR, 29(9): 1-8, 2019; Article no.JAMMR.48883 2 represents 15.9% of the total sample population -and were concentrated among the older patients (>13 years old). Conclusions: Although this retrospective study does not have a sufficient sample size to provide more robust analysis of other risk factors (race, sex, sociodemographic), these results to demonstrate that oral HPV infection may be successfully detected among a pediatric population. As more studies demonstrate oral HPV infection in children, these data are of significant value to other dental, medical, oral and public health professionals who seek to further an understanding of oral health and disease risk in pediatric populations. Original Research Article

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“…Not only is overall survival after distant failure longer in these patients, but about one third of oligometastatic cases in the lungs can be cured with either surgery or radiotherapy (7,30). Noteworthy, compared with their HPV-negative; counterparts, patients with HPV-positive oropharyngeal cancer present more often with dissemination to more than two organs (about one third of cases) that can also involve unusual localizations such as the skeletal muscles, pericardial lymph nodes, kidney, or pancreatic tail (6)(7)(8). Therefore, careful evaluation and sometimes even multiple biopsies are warranted in these cases.…”

Section: Clinical Pre-treatment Considerationsmentioning

confidence: 99%

“…They usually occur within 2–3 years of diagnosis with the notable exception of a small proportion (probably more than 10%) of human papillomavirus (HPV)-positive oropharyngeal cancer cases, which continue to metastasize for a longer period of time, even beyond 6 years ( 6 , 7 ). Interestingly, in a recent meta-analysis of seven studies, time to distant progression was 0.2–106 months and 0.2–33 months in HPV-positive and HPV-negative oropharyngeal cancer patients, respectively ( 8 ).…”

Section: Distant Metastases: Who How and Whatmentioning

confidence: 99%

Oligometastatic Disease Management: Finding the Sweet Spot

Szturz¹,

Nevens

Vermorken

2020

Front. Oncol.

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Hematogenous dissemination represents a common manifestation of squamous cell carcinoma of the head and neck, and the recommended therapeutic options usually consist of systemically administered drugs with palliative intent. However, mounting evidence suggests that patients with few and slowly progressive distant lesions of small size may benefit from various local ablation techniques, which have already been established as standard-of-care modalities for example in colorectal and renal cell carcinomas and in sarcomas. In principle, serving as radical approaches to eradicate cancer, these interventions can be curative. Their impact on local control and overall survival has been shown in numerous retrospective and prospective studies. The term oligometastatic refers to the number of distant lesions which should generally not surpass five in total, ideally in one organ. Currently, surgical resection remains the method of choice supported by the majority of published data. More recently, stereotactic (ablative) body radiotherapy (SABR/SBRT) has emerged as a viable alternative. In cases technically amenable to such local interventions, several other clinical variables need to be taken into account also, including patient-related factors (general health status, patient preferences, socioeconomic background) and disease-related factors (primary tumor site, growth kinetics, synchronous or metachronous metastases). In head and neck cancer, patients presenting with late development of slowly progressive oligometastatic lesions in the lungs secondary to human papillomavirus (HPV)-positive oropharyngeal cancer are the ideal candidates for metastasectomy or other local therapies. However, literature data are still limited to say whether there are other subgroups benefiting from this approach. One of the plausible explanations is that radiological follow-up after primary curative therapy is usually not recommended because its impact on survival has not been unequivocal, which is also due to the rarity of oligometastatic manifestations in this disease. At the same time, aggressive treatment of synchronous metastases early in the disease course should be weighed against the risk of futile interventions in a disease with already multimetastatic microscopic dissemination. Therefore, attentive treatment sequencing, meticulous appraisal of cancer extension, refinement of post-treatment surveillance, and understanding of tumor biology and kinetics are crucial in the management of oligometastases.

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Systematic review on location and timing of distant progression in human papillomavirus‐positive and human papillomavirus‐negative oropharyngeal squamous cell carcinomas

Cited by 16 publications

References 28 publications

Rate of locoregional recurrence among patients with oropharyngeal squamous cell carcinoma with known HPV status: a systematic review

Rate of locoregional recurrence among patients with oropharyngeal squamous cell carcinoma with known HPV status: a systematic review

Screening for Oral High-risk Human Papillomavirus (HPV) among a Pediatric Patient Population

Oligometastatic Disease Management: Finding the Sweet Spot

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