PLoS ONE (Jan 2017)

The prognostic impact of human papillomavirus status following treatment failure in oropharyngeal cancer.

  • Eesha Dave,
  • Umut Ozbek,
  • Vishal Gupta,
  • Eric Genden,
  • Brett Miles,
  • Marita Teng,
  • Marshall Posner,
  • Krzysztof Misiukiewicz,
  • Richard L Bakst

DOI
https://doi.org/10.1371/journal.pone.0181108
Journal volume & issue
Vol. 12, no. 7
p. e0181108

Abstract

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Despite the human papillomavirus conferring a better prognosis in the primary treatment setting, the prognostic impact of viral status after treatment failure in oropharyngeal squamous cell carcinoma patients is poorly understood.We retrospectively identified 33 oropharyngeal squamous cell carcinoma (OPC) patients with local and/or distant disease recurrence post-treatment, and looked at metastatic patterns, time to failure and survival patterns by HPV status.Median overall survival following local failure was not significantly different by HPV status (17 months for HPV+ vs. 14 months for HPV-, p = 0.23). However, following distant failures, HPV+ patients lived significantly longer than HPV- patients (median 42 months vs. 11 months, p = 0.004). HPV- patients were more likely to have locoregional failures as compared to HPV+ patients (p = 0.005), but the difference in distant failure between both groups was not significant (p = 0.09). HPV+ patients were more likely to develop metastases to sites other than the lung and bones.HPV positivity predicts a favorable prognosis with the potential for long-term survival following distant, not locoregional, failures. These results have important implications for the aggressiveness of treatment and type of surveillance imaging performed.