Unique Patterns of Distant Metastases in HPV-Positive Head and Neck Cancer

Oncology. 2020;98(3):179-185. doi: 10.1159/000504651. Epub 2019 Dec 17.

Abstract

Background: HPV-positive head and neck squamous cell carcinoma (HPV+ HNSCC) demonstrates favorable outcomes compared to HPV-negative SCC, but distant metastases (DM) still occur. The pattern of DM in HPV+ HNSCC is unclear.

Methods: 1,494 HNSCC patients were treated from 2006 to 2012. Recurrence time and metastatic sites in HPV+ HNSCC (Group 1) were compared to patients with HPV-negative/unknown cancers arising in the hypopharynx, larynx, or glottis (Group 2) as well as to patients with HPV-negative/unknown cancers in theoral cavity, oropharynx, hard palate, or tonsil (Group 3).

Results: 7/109 (6.4%) patients with HPV+ HNSCC developed DM. The median time to metastases was 11 months. At a median follow-up of 18-25 months, there was no difference in the overall rate of DM for the HPV+ HNSCC group compared to Group 2 (HPV-/unknown) (p = 0.21) and Group 3 (HPV-/unknown) (p = 0.13). There was a significant difference in the rate of DM to the lung in the HPV+ HNSCC group compared to Group 2 (HPV-/unknown) (p = 0.012) and Group 3 (HPV-/unknown) (p = 0.002).

Conclusions: There was no observed difference in the time to development of DM between the HPV-/unknown and HPV+ HNSCC groups. However, the HPV+ HNSCC group showed a higher rate of DM to the lung compared to the HPV-/unknown -HNSCC group (p = 0.002).

Keywords: Distant metastases; HPV positivity; Head and neck cancer.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Disease Progression
  • Female
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy
  • Head and Neck Neoplasms / virology*
  • Humans
  • Male
  • Middle Aged
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / therapy
  • Papillomavirus Infections / virology*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Squamous Cell Carcinoma of Head and Neck / secondary*
  • Squamous Cell Carcinoma of Head and Neck / therapy
  • Squamous Cell Carcinoma of Head and Neck / virology*
  • Time Factors
  • Treatment Outcome