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International Journal of Otolaryngology
Volume 2013, Article ID 437815, 9 pages
http://dx.doi.org/10.1155/2013/437815
Clinical Study

HPV Prevalence and Prognostic Value in a Prospective Cohort of 255 Patients with Locally Advanced HNSCC: A Single-Centre Experience

1Department of Head and Neck Surgery, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Est, Montreal (Quebec), Canada H2L 4M1
2Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, 5415 Boulevard de l'Assomption, Montréal (Quebec), Canada H1T 2M4
3Department of Microbiology, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Est, Montreal (Quebec), Canada H2L 4M1
4Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Est, Montreal (Quebec), Canada H2L 4M1
5Department of Haematology and Medical Oncology, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Est, Montreal (Quebec), Canada H2L 4M1
6Laboratoire de Biologie Moléculaire et Hématologie Spéciale, Département d’Hématologie, Hématologue et Oncologue Médical, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Est, Montreal (Quebec), Canada H2L 4M1

Received 4 January 2013; Revised 28 March 2013; Accepted 28 March 2013

Academic Editor: David W. Eisele

Copyright © 2013 E. Thibaudeau et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. HPV is a positive prognostic factor in HNSCC. We studied the prevalence and prognostic impact of HPV on survival parameters and treatment toxicity in patients with locally advanced HNSCC treated with concomitant chemoradiation therapy. Methods. Data on efficacy and toxicity were available for 560 patients. HPV was detected by PCR. Analysis was performed using Kaplan-Meier survival curves, Fisher’s test for categorical data, and log-rank statistics for failure times. Results. Median follow-up was 4.7 years. DNA extraction was successful in 255 cases. HPV prevalence was 68.6%, and 53.3% for HPV 16. For HPV+ and HPV−, median LRC was 8.9 and 2.2 years ( ), median DFS was 8.9 and 2.1 years ( ), and median OS was 8.9 and 3.1 years ( ). Survival was different based on HPV genotype, stage, treatment period, and chemotherapy regimen. COX adjusted analysis for T, N, age, and treatment remained significant ( ). Conclusions. Oropharyngeal cancer is increasingly linked to HPV. This study confirms that HPV status is associated with improved prognosis among H&N cancer patients receiving CRT and should be a stratification factor for clinical trials including H&N cases. Toxicity of CRT is not modified for the HPV population.