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Patients With HPV-Positive and HPV-Negative Oropharyngeal Cancer May Have Different Rates of Mortality


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New research indicates that there is a higher risk of early death among patients with oropharyngeal cancer not associated with human papillomavirus (HPV) vs those whose tumors are HPV-positive. The findings are published by Fullerton et al in Cancer. 

The incidence of oropharyngeal cancer is increasing in the United States. Recent evidence has shown that approximately 75% of these cancers are due to infection with HPV.

Study Design

A team led by Danielle N. Margalit, MD, MPH, of Dana-Farber/Brigham & Women’s Cancer Center and Harvard Medical School, designed a study to better understand the causes and risks of early death among patients with oropharyngeal cancer and to determine how these risks differ in patients with and without HPV-related tumors.

The researchers’ analysis included information on 4,930 patients in the United States who were diagnosed with nonmetastatic oropharyngeal cancer from 2013 to 2014, including 3,560 whose cancers were HPV-positive and 1,370 whose cancers were HPV-negative. Patients were followed for a median of 11 months.

KEY POINTS

  • Compared with patients whose cancers were HPV-negative, those whose cancers were HPV-positive had a lower risk of dying from any cause within 2 years (10.4% vs 33.3%) and a lower risk of dying from head and neck cancer (4.8% vs 16.2%).
  • Patients who had HPV-positive oropharyngeal cancer also had a lower risk of dying from cancers other than head and neck cancer.

Results

Compared with patients whose cancers were HPV-negative, those whose cancers were HPV-positive had a lower risk of dying from any cause within 2 years (10.4% vs 33.3%) and a lower risk of dying from head and neck cancer (4.8% vs 16.2%). Patients who had HPV-positive oropharyngeal cancer also had a lower risk of dying from cancers other than head and neck cancer.

“The study is really eye-opening when it comes to the high risk of death among patients with HPV-negative oropharyngeal cancer,” said Dr. Margalit. “The information can be put to use by clinicians who see patients after treatment. They need to be vigilant not just about head and neck cancer recurrence, but also about screening for other cancers and noncancer comorbidities that can influence patients’ risk of early death, and they should counsel patients on addressing modifiable risk factors.”

Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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