The course of health-related quality of life from diagnosis to two years follow-up in patients with oropharyngeal cancer: does HPV status matter?

Abstract

Purpose To investigate the course of health-related quality of life (HRQOL) from diagnosis to 2 years follow-up among patients with oropharyngeal cancer (OPSCC), in relation to human papilloma virus (HPV) status. Methods This study included 270 OPSCC patients. Age, sex, tumor sublocation, tumor stage, HPV status, treatment modality, comorbidity, smoking, and alcohol use were retrieved from medical records. HPV status was positive when p16 and HPV DNA tests were both positive. HRQOL was assessed using the EORTC QLQ-C30/QLQ-H&N35 pretreatment and at 6 weeks, 6, 12, 18, and 24 months after treatment. To compare the course of HRQOL between patients with an HPV-positive versus HPV-negative tumor, linear and logistic mixed models were used. Results Patients with an HPV-positive tumor (29%) were more often male, diagnosed with a tumor of the tonsil or base of the tongue, treated with single treatment, had fewer comorbidities, were less often current smokers and had lower alcohol consumption. Adjusted for confounders, the course of global quality of life, physical, role, and social functioning, fatigue, pain, insomnia, and appetite loss was significantly different: patients with an HPV-positive tumor scored better before treatment, worsened during treatment, and recovered better and faster at follow-up, compared to patients with an HPV-negative tumor. The course of emotional functioning and oral pain was also significantly different between the two groups, but with other trajectories. Conclusion The course of HRQOL is different in patients with an HPV-positive tumor versus an HPV-negative tumor, adjusted for sociodemographic, clinical, and lifestyle confounders.

The changing face of head and neck cancer: are patients with human papillomavirus-positive disease at greater nutritional risk? A systematic review

“…The impact of a higher perceived intensity of radiation-induced pain [ 45 ], potentially due to the lower smoking rates seen for OPC+ versus OPC− [ 46 ], and higher levels of fatigue [ 47 ] reported for the OPC+ population may also increase this risk of critical weight loss further. Given patients with OPC+ often report higher QoL and minimal symptoms at diagnosis, they may perceive a larger decrease in their QoL when the impacts of acute toxicities become apparent, increasing patients distress, compared to those with OPC− disease already experiencing tumour burden at diagnosis [ 18 , 19 , 48 ]. It has been demonstrated that as the acuity of treatment side effects worsen, impacting on nutritional intake, weight loss for many becomes uncontrolled, worsening patient-reported distress [ 49 ].…”

Association of Deficits Identified by Geriatric Assessment With Deterioration of Health-Related Quality of Life in Patients Treated for Head and Neck Cancer

“…Furthermore, limitations were the relative heterogeneity of the cohort and absence of data on human papillomavirus status, which may influence HRQOL decline as well. 71…”

Understanding the Pattern of Oropharyngeal Cancers from North-East Romanian Patients

“…For the very pragmatic question, "Does HPV status matter? ", the authors found that HPV-positive OPSCC patients had a better score before treatment, recovered faster, and had a different course of emotional functioning, in comparison to HPV-negative patients [37]. A research team from Denmark investigated, in a review study, the impact of specific HPV genotypes on survival in HPV+ OPSCC and identified a favorable prognosis among patients with HPV16 OPSCC compared with HR non-HPV16 OPSCC [38].…”