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Relationship to Survival

Gary L. Clayman, DDS, MD; Michael G. Stewart, MD; Randal S. Weber, MD; Adel K. El-Naggar, MD, PhD; Elizabeth A. Grimm, PhD

Arch Otolaryngol Head Neck Surg. 1994;120(7):743-748.

Abstract
Objective
To determine the relationship between human papillomavirus (HPV) DNA detection in upper aerodigestive tract malignancies and patient outcome.

Design
Archival paraffin-embedded specimens from 78 previously untreated patients with squamous carcinomas of the larynx and hypopharynx were pathologically verified and analyzed by polymerase chain reaction for detection of HPV DNA. Charts were independently reviewed and coded until final analysis.

Setting
The University of Texas M. D. Anderson Cancer Center, Houston, a tertiary cancer referral center.

Results
DNA was successfully extracted from 65 archival patient samples (83%). The mean (±SEM) duration of follow-up for these patients was 42±21 months. Thirty specimens (46%) exhibited detectable HPV DNA. Detection of HPV was significantly related to decreased survival, independent of disease stage. Log rank testing revealed that HPV detection, pathologic vascular invasion, and nodal status were the most significant predictors of death of disease.

Conclusions
Laryngeal and hypopharyngeal carcinomas with detectable HPV may represent a biologically distinct subset of tumors that carry a poorer prognosis than do cancers with no detectable HPV.

(Arch Otolaryngol Head Neck Surg. 1994;120:743-748)

Author Affiliations
From the Departments of Head and Neck Surgery (Drs Clayman and Weber), Pathology (Dr El-Naggar), and Tumor Biology (Dr Grimm), The University of Texas M. D. Anderson Cancer Center, Houston, and the Department of Otolaryngology, Baylor College of Medicine, Houston (Dr Stewart).

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