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Human papillomavirus in laryngeal and hypopharyngeal carcinomas. Relationship to survival
G L Clayman1, M G Stewart, R S Weber
1Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston.
Objective:
To determine the relationship between human papillomavirus (HPV) DNA detection in upper aerodigestive tract malignancies and patient outcome.
Design:
Archival paraffin-embedded specimens from 78 previously untreated patients with squamous carcinomas of the larynx and hypopharynx were pathologically verified and analyzed by polymerase chain reaction for detection of HPV DNA. Charts were independently reviewed and coded until final analysis.
Setting:
The University of Texas M. D. Anderson Cancer Center, Houston, a tertiary cancer referral center.
Results:
DNA was successfully extracted from 65 archival patient samples (83%). The mean (+/- SEM) duration of follow-up for these patients was 42 +/- 21 months. Thirty specimens (46%) exhibited detectable HPV DNA. Detection of HPV was significantly related to decreased survival, independent of disease stage. Log rank testing revealed that HPV detection, pathologic vascular invasion, and nodal status were the most significant predictors of death of disease.
Conclusions:
Laryngeal and hypopharyngeal carcinomas with detectable HPV may represent a biologically distinct subset of tumors that carry a poorer prognosis than do cancers with no detectable HPV.