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. 2022 Jul 25:10:900294.
doi: 10.3389/fpubh.2022.900294. eCollection 2022.

The effect of human papillomavirus status on prognosis and local treatment strategies of T1-2N0 oropharyngeal squamous cell cancer

Ping Zhou  1 , Deng-Lin Chen  2 , Chen-Lu Lian  1 , San-Gang Wu  1 , Shi-Yang Zhang  3
Affiliations

The effect of human papillomavirus status on prognosis and local treatment strategies of T1-2N0 oropharyngeal squamous cell cancer

Ping Zhou et al. Front Public Health. .

Abstract

Purpose: To explore the effect of human papillomavirus (HPV) status on prognosis and further investigate whether human papillomavirus (HPV) status has an impact on the local treatment strategies for T1-2N0 oropharyngeal squamous cell cancer (OPSCC) patients.

Methods: Patients diagnosed with T1-2N0 OPSCC between 2010 and 2015 were included from the Surveillance, Epidemiology, and End Results database. Data were analyzed using propensity score matching (PSM), Chi-square test, Kaplan-Meier survival analysis, and Cox multivariable analyses.

Results: A total of 1,004 patients were identified, of whom 595 (59.3%) had HPV-related tumors. Of all the patients, 386 (38.4%) and 618 (61.6%) received definitive radiotherapy and radical surgery, respectively. HPV status had no significant effect on local treatment strategies for early-stage OPSCC (P = 0.817). The 3-year cancer-specific survival (CSS) and overall survival (OS) were 89.6 and 80.1%, respectively. Compared to those with HPV-negative diseases, patients with HPV-positive diseases had better CSS and OS. A total of 222 pairs of patients were completely matched after PSM. The results of multivariate Cox regression analysis showed that patients with HPV-positive disease had significantly better CSS (P = 0.001) and OS (P < 0.001) compared to those with HPV-negative tumors. However, local treatment strategy was not associated with survival outcomes after PSM (CSS, P = 0.771; OS, P = 0.440). The subgroup analysis showed comparable CSS and OS between those treated with radical surgery and definitive radiotherapy regardless of HPV status.

Conclusions: HPV status is an independent prognostic factor for the survival of stage T1-2N0 OPSCC patients. Local treatment strategies had no significant effect on the survival of early-stage OPSCC regardless of HPV status. Patients with early-stage OPSCC should be informed regarding the pros and cons of definitive radiotherapy or radical surgery.

Keywords: human papillomavirus; oropharyngeal squamous cell cancer; prognosis; radiotherapy; surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patients' treatment strategies according to the year of diagnosis.
Figure 2
Figure 2
Kaplan-Meier plots of cancer-specific survival (A) and overall survival (B) by HPV status before propensity score matching (PSM).
Figure 3
Figure 3
Kaplan-Meier plots of cancer-specific survival (A) and overall survival (B) for HPV-negative patients and cancer-specific survival (C) and overall survival (D) for HPV-positive patients before PSM.
Figure 4
Figure 4
Kaplan-Meier plots of cancer-specific survival (A) and overall survival (B) for HPV-negative patients and cancer-specific survival (C) and overall survival (D) for HPV-positive patients after PSM.
See this image and copyright information in PMC

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