Assessment of HPV16 infection in patients with laryngeal cancer

Abstract

The purpose of the study was to investigate HPV16 infection in laryngeal cancer patients treated with surgery and adjuvant radiotherapy as well as to analyze treatment results in relation to HPV16 infection and selected clinical, histopathological, and radiotherapy parameters. A retrospective analysis was performed in a group of 60 patients with squamous cell carcinoma of the larynx treated surgically and qualified for adjuvant radiotherapy at the Oncology Center in Cracow between 1995 and 2001. The studied group consisted of 57 men (95%) and 3 women (5%) of mean age of 56 years. In 13 patients (22%) underweight was noted. In the analyzed material, locally advanced laryngeal cancer prevailed (pT3-pT4) -52 cases (87%), with the involvement of cervical lymph nodes (pN+) -32 cases (53%). Histopathological examination revealed that microscopic radicality was not obtained in 18 patients (30%). Human papillomavirus 16 infection status as well as infection type (integrated, episomal, or mixed) were assessed in each patient by means of quantitative polymerase chain reaction (qPCR) using real-time detection. The 5-year OS, DFS, and LC rates were 45%, 61%, and 69%, respectively. Multivariate analysis revealed that local relapse risk and local failure risk were statistically significantly influenced by underweight and positive surgical margin. Underweight had also a statistically significant impact on death risk. The HPV16 infection was noticed in 4 cancers (6.8%). In all cases it was the same episomal type. On the basis of our observations it can be assumed that HPV infection does not play an important role in etiology of laryngeal cancer. Although, further study is needed in larger patient populations; optimal methodology for detecting HPV infection should also be determined. Positive surgical margin has a significant effect on worse treatment outcomes. Underweight before radiotherapy diminishes the probability of treatment success and survival of laryngeal cancer patients.

Clinical Relevance of Resection Margins in Patients with Total Laryngectomy or Laryngopharyngectomy

“…The remaining nine articles used descriptive definitions for margin status, such as ‘positive’, ‘microscopically positive’, ‘tumor at the resection surface’, ‘negative’, ‘safe margins’ or ‘no invasive tumor at the resection surface’. These studies reported clear margins in 70–100% and positive margins in 0–30% [ 10 , 11 , 12 , 14 , 16 , 17 , 18 , 19 , 20 ]. The results of our survival data cannot be compared with those in the literature because diverse patient cohorts and descriptive definitions for margin status have been used in different studies.…”