Time to change perspectives on HPV in oropharyngeal cancer. A systematic review of HPV prevalence per oropharyngeal sub-site the last 3 years

Abstract

ObjectivesHuman papillomavirus (HPV) as a risk factor in oropharyngeal squamous cell carcinoma (OPSCC) is well established. However, accumulating data imply that the OPSCC concept is too unspecific with regard to HPV prevalence and clinical importance. To further study the role of HPV in OPSCC by sub-site, a systematic review and meta-analysis was performed.Material and methodPubMed was searched and all studies reporting HPV data (p16/HPV DNA/RNA) in both “lymphoepithelial associated” (i.e. tonsillar and base of tongue cancer; TSCC and BOTSCC respectively) and “non-lymphoepithelial” (“other” OPSCC) OPSCC were included. Pooled odds ratios by HPV detection method were analysed using a random effects model.ResultsIn total, 58 unique patient cohorts were identified. Total HPV prevalence in TSCC/BOTSCC was 56%, 95%CI: 55–57% (59%, 95%CI: 58–60% for TSCC only) as compared to 19%, 95%CI: 17–20%, in “other” OPSCC. Significant association of HPV to TSCC/BOTSCC vs. “other” OPSCC was observed no matter HPV detection method used, but statistical homogeneity was only observed when studies using algorithm based HPV detection were pooled.ConclusionHPV prevalence differs markedly between OPSCC sub-sites and while the role of HPV in TSCC/BOTSCC is strong, the role in “other” OPSCC is more uncertain and needs further evaluation.

Human papillomavirus and survival of patients per histological subsite of tonsillar squamous cell carcinoma

“…Open Access walls) had lower HPV prevalence, similar to that in oral cancer [4]. Furthermore, recent data also imply that the prognostic impact of HPV differs between these subsites [5][6][7][8][9][10][11][12][13].…”

“…However, accumulating data suggests that OPSCC should be divided into subsites when assessing HPV and outcome. In a recent published meta-analysis, the HPV prevalence varied considerably between different OPSCC subsites [4]. While tumors arising in tissues harboring crypts (TSCC and BOTSCC) had high HPV numbers, the tumors at the other subsites (cancer of the soft palate and oropharyngeal ORIGINAL RESEARCH Human papillomavirus and survival of patients per histological subsite of tonsillar squamous cell carcinoma Abstract Current data advocate that oropharyngeal squamous cell carcinoma (OPSCC) should be divided into subsites when evaluating the presence of human papillomavirus (HPV) and prognosis.…”

Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study

“…9 Finally, the large meta-analysis by Ndiaye et al reported that tonsil/BOT (53.9% and 47.8%) had a higher HPV incidence compared to soft palate (11.7%). This prevalence was also similar to our previous study utilizing the SEER database (73.0% vs 31.2%, respectively, P < .001).…”

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

“…Among the oropharyngeal subsites, HPV association was strongest among tonsillar carcinomas, with pooled estimates varying from 56 to 66.4%, followed by the base of the tongue carcinoma with pooled HPV prevalence between 40 and 56%. OPSCC originating from the soft palate or posterior wall had much lower estimates for HPV prevalence: 12 and 19%, respectively [30, 34, 35, 56]. …”