Impact of HPV status on metastatic patterns and survival in non-oropharyngeal head and neck cancer with distant metastasis.

PURPOSE

Because of the lack of data and studies on metastatic non-oropharyngeal head and neck cancer (non-OP HNC), the role of human papillomavirus (HPV) status in non-OP HNC with distant metastasis is still unclear. Therefore, we conducted a study to explore the differences in metastatic patterns, survival and treatment responses in metastatic non-OP HNC based on HPV status.

METHODS

A total of 333 metastatic non-OP HNC patients were diagnosed from 2010 to 2016 in the Surveillance, Epidemiology and End Results (SEER) database. The chi-square test and Fisher's exact test were used to make comparisons for categorical variables. The Kaplan-Meier method and Cox regression analyses were used to analyse survival.

RESULTS

HPV status was a significant prognostic variable for patients with non-OP HNC with distant metastasis. HPV- patients were more likely to have distant metastasis and worse prognosis and treatment response than HPV+ patients. Only chemotherapy was an independent prognostic factor for HPV+ patients with distant metastasis, while chemotherapy and radiotherapy were both independent prognostic factors for HPV- patients with distant metastasis. The treatment response was associated with the metastatic pattern in both HPV+ and HPV- populations and showed significant differences based on HPV status and metastatic pattern.

CONCLUSIONS

For non-OP HNC with distant metastasis, HPV+ and HPV- patients formed two different cohorts in terms of metastatic pattern, survival and treatment. Therefore, it is helpful to classify metastatic non-OP HNC into different groups to choose appropriate treatment strategies according to HPV status and metastatic pattern.