HUMAN PAPILLOMAVIRUS IN LARYNGEAL AND HYPOPHARYNGEAL CARCINOMAS - RELATIONSHIP TO SURVIVAL

Objective: To determine the relationship between human papillomavirus (HPV) DNA detection in upper aerodigestive tract malignancies and pati ent outcome. Design: Archival paraffin-embedded specimens from 78 prev iously untreated patients with squamous carcinomas of the larynx and h ypopharynx were pathologically verified and analyzed by polymerase cha in reaction for detection of HPV DNA. Charts were independently review ed 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 sam ples (83%). The mean (+/-SEM) duration of follow-up for these patients was 42+/-21 months. Thirty specimens (46%) exhibited detectable HPV D NA. Detection of HPV was significantly related to decreased survival, independent of disease stage. Log rank testing revealed that HPV detec tion, pathologic vascular invasion, and nodal status were the most sig nificant predictors of death of disease. Conclusions: Laryngeal and hy popharyngeal carcinomas with detectable HPV may represent a biological ly distinct subset of tumors that carry a poorer prognosis than do can cers with no detectable HPV.