Human Papillomavirus in Non-Oropharyngeal Head and Neck Cancers: A Systematic Literature Review

Abstract

Perhaps one of the most important developments in head and neck oncology of the past decade is the demonstration that patients with human papillomavirus (HPV)-mediated oropharyngeal cancers have significantly improved outcomes, compared to HPV-negative counterpart patients. This has become the basis for clinical trials investigating the impact on ''treatment deintensification'' for patients with HPV-mediated oropharyngeal cancers. Unfortunately, the significance of HPV in non-oropharyngeal head and neck cancers is much less certain. Our goal is to systematically review the published data regarding the role HPV in carcinomas of the oral cavity, larynx, sinonasal tract and nasopharynx with respect to HPV detection frequency, viral activity, and association with outcome. We also present preliminary data on HPV16/18 transcriptional status in oral cavity carcinomas, as well as salivary gland neoplasia, as determined by nested reverse transcription PCR for HPV E6/E7 RNA. The weighted prevalence (WP) of HPV DNA detection in 4,195 oral cavity cancer patients is 20.2 %, (95 % CI 16.0 %, 25.2 %). HPV16 is the most common type detected. Importantly, no data currently demonstrates a significant association between the presence of HPV DNA and improved outcome. The WP of HPV DNA in 1,712 laryngeal cancer patients is 23.6 %, (95 % CI 18.7 %, 29.3 %). Similarly, no association has yet been demonstrated between HPV DNA status and outcome. The WP of HPV DNA detection in 120 sinonasal cancer patients is 29.6 % (95 % CI 17.8 %, 44.9 %), and in 154 nasopharyngeal carcinoma patients is 31.1 %, (95 % CI 20.3 %, 44.5 %). Recent preliminary data also suggests an association between HPV and certain salivary gland neoplasms. The clinical significance of these findings is unclear. The published data strongly support the need for studies on patients with oral and laryngeal carcinomas that will be powered to find any differences in clinical outcome with respect to HR-HPV and p16 overexpression.

Survival Analysis of Oral Squamous Cell Carcinoma in a Subgroup of Young Patients

“…However, high rates of HPV infection have rarely been demonstrated in the oral cavity and are an unlikely explanation for the increased incidence and impact the survival rate of younger patients (Isayeva et al, 2012). Goot-Heah et al (2012) indicated a low viral load of high-risk HPV in Malaysian OSCC by analysing virus PCR product from saliva samples, suggesting the prevalence of HPV infection may not be important in Malaysian OSCC.…”

Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: What is New in the 2017 WHO Blue Book for Tumours of the Hypopharynx, Larynx, Trachea and Parapharyngeal Space

“…Over the last three decades, the high-risk HPV genotypes (hrHPV) have been confirmed as the major etiologic factor of the subset of oropharyngeal SCC, dominating in the western part of the world [14,15]. The significance of hrHPV infection in the development of tumours in oral cavity, hypopharynx and larynx needs to be additionally elucidated [1,2,[16][17][18]. Controversial data on hrHPV DNA prevalence in hypopharyngeal and laryngeal SCC has been published; prevalence varied considerably, from 5 to 60% [4,19,20].…”

Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India

“…A specific role was hypothesized way back in 1983, but till date, a definite consensus still awaits the light of the day [6][7][8]. The healthy adult population has showed prevalence for any HPV type of 2-8 % in OCSCC [9][10][11][12][13][14] with a higher preponderance for male sex worldwide [11][12][13]15] whereas previous Indian studies have reported a wide variation in HPV positivity prevalence from northeastern, eastern, and southern different regions of the country [16][17][18][19][20]. Further high-risk sexual behavior including oral genital sex and multiple sexual partners has been found to be associated with HPV transmission [12,21,22].…”