Flores-de la Torre C, Hernández-Hernández DM, Gallegos-Hernández JF

Language: Spanish
References: 21
Page: 221-228
PDF size: 401.00 Kb.

ABSTRACT

Background: The three most important prognostic factors in patients with head and neck squamous cell carcinoma (HNSCC) are tumor size, nodular histological condition and tumor origin. Recently, human papilloma virus (HPV), particularly HPV-16, has been acknowledged as a prognostic factor. HPV+ patients have better survival than HPV-. This has created a controversy because other factors may influence the prognosis. The objective of this study was to investigate whether HPV has prognostic value in patients with HNSCC.
Methods: We carried out a retrospective evaluation of patients with HNSCC and the following variables were analyzed: survival, tumor location, stage, general condition according to Eastern Cooperative Oncology Group (ECOG) status, treatment and HPV association identified by PCR. We used a descriptive analysis of simple frequencies and central tendency and dispersion measures according to the type of variables. We used descriptive analysis for overall survival with Kaplan- Meier and Cox regression with 95% confidence interval.
Results: There were 179 patients included: 119 (66.5%) were male. Average age of patients was 64 years; 34% of the tumors were located in the oral cavity and 33% were located in the larynx. Factors associated with survival were ECOG (RR = 11.3; 2.6-48), clinical stage (RR = 7.8; 1.7-34), age 󉛮 years (RR = 3.5, 1.4-8.5) and nonsurgical treatment (RR = 2.3; 1.4-3.8). Average overall survival for patients with HPV16 was 22 months vs. 28 months in those with other types of viruses. HPV infection was not associated with the prognosis in this series.
Conclusions: ECOG at the time of the diagnosis and clinical stage were the most significant prognostic factors in this series. HPV did not show any prognostic value.

REFERENCES

1. Gallegos-Hernández JF. El cáncer de cabeza y cuello. Factores de riesgo y prevención. Cir Ciruj 2006;74:287-293.

2. Parkin DM, Bray FI, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer 2001;94:153-156.

3. Gallegos-Hernández JF, Hernández-Hernández DM, Flores-Díaz R, Apresa-García T, Minauro-Muñoz G, Arias-Ceballos H. Frequency and types of human papilloma virus in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 2006;132(8):897.

4. Sikoara AG, Morris LGT, Shurgis EM. A population-based analysis of the association of oral/pharyngeal carcinomas with HPV-related anogenital cancers in men. Proceedings of the 7th Int Conference on Head and Neck Cancer. San Francisco: 2008; S-361.

5. Yohodom R, Bedrin L, Vered M, Talmi YP, Pheffer R, Teicher S, et al. Squamous cell carcinoma of oral tongue in young adults: a clinical and pathological analysis of risking etiologic entity. Proceedings of the 7th Int Conference on Head and Neck Cancer. San Francisco: 2008; S363.

6. Hafkamp HC, Haesevoets A, Voogd AC, Schepers M, Bot FJ, Hopman AH, et al. Marked differences in survival rate between smokers and nonsmokers with HPV 16-associated tonsillar carcinomas. Int J Cancer 2008;15:2656-2664.

7. Shiboski CH, Da Costa MM, Palefsky JM, Jordan RCK. Lack of association between HPV infection and oral tongue carcinoma in young and older patients. S362. Proceedings of the 7th Int Conference on Head and Neck Cancer. San Francisco: 2008; S362.

8. Laurence J. HPV-linked oral cancer: another argument for universal HPV vaccination of boys and girls. AIDS Read 2008;18:345-346.

9. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009;45:309-316.

10. Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. Cancer statistics. CA Cancer J Clin 2006;56:106-130.

11. Dirección General de Epidemiología. Compendio del registro histopatológico de neoplasias en México. Morbilidad y mortalidad. México: Secretaría de Salud; 1996. p. 130.

12. Dirección General de Epidemiología. Inforcompendio de registro histopatológico de neoplasias malignas en México 1993-1997. México: Secretaría de Salud; 1998. Disponible en http//www.degepi.salud.gob.mx

13. Jarret WFH. Environmental carcinogens and papillomaviruses in the pathogenesis of cancer. Proc R Soc Lond B Biol Sci 1987;231:1-11.

14. Mineta H, Ogino T, Amano HM. Human papilloma virus (HPV) type 16 and 18 detected in head and neck squamous cell carcinoma. Anticancer Res 1998;18:4765-4768.

15. Chen B, Yin H, Dhurandhar N. Detection of human papillomavirus DNA in esophageal squamous cel carcinomas by the polymerase chain reaction using general consensus primers. Hum Pathol 1994;25:920-923.

16. Gulley ML. Molecular diagnosis of Epstein-Barr virus-related diseases. J Mol Diagn 2001;3:1–10.

17. Gallegos-Hernández JF, Hernández-Hernández DM, Flores-Díaz R, Arias-Ceballos H, Minauro-Muñoz GG, Hernández-Sanjuan M, et al. Human papilloma virus in head and neck cancer patients. 1st Meeting Int Academy of Oral Oncology. Amsterdam: May 2007; Abstr. P138. Oral Oncol Head Neck Oncol Pathol Suppl 2007:173.

18. Chang F, Syrhänen S, Shen Q, Ji H, Syrjänene K. Human papillomavirus (HPV) DNA in esophageal precancer lesions and squamous cell carcinomas from China. Int J Cancer 1990;45:21-25.

19. Smit HL, Tjong-A-Hung SP, Ter Shegget J, Nooter K, Kok T. Absence of human papillomavirus DNA from esophageal carcinoma as determined by multiple broad spectrum polymerase chain reactions. J Med Virol 1995;46:213-215.

20. Brandsma JL, Abramson AL. Association of papillomavirus with cancers of the head and neck. Arch Otolaryngol Head Neck Surg 1989;115:621-625.

21. Paz IB, Cook N, Odom-Maryon T, Xie Y, Wilczynski SP. Human papillomavirus (HPV) in head and neck cancer. An association of HPV 16 with squamous cell carcinoma of Waldeyer’s tonsillar ring. Cancer 1997;79:595–604.