Costantino Andrea, Magnuson Jeffery Scott, Alamoudi Uthman, Haughey Bruce
Department of Otolaryngology - Head and Neck Surgery, AdventHealth Orlando, Orlando, Florida, U.S.A.
Department of Otolaryngology - Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, U.S.A.
Laryngoscope. 2025 Feb;135(2):695-704. doi: 10.1002/lary.31775. Epub 2024 Sep 18.
The prognostic significance of human papillomavirus (HPV) genotypes in oropharyngeal squamous cell carcinoma (OPSCC) has garnered considerable attention due to the increasing reliance on HPV status for clinical decision-making. This study aimed to compare the survival outcomes associated with different HPV genotypes in patients with OPSCC relative to HPV-negative tumors, providing insights into the potential implications for treatment de-intensification strategies.
Patients diagnosed with invasive OPSCC were included from the National Cancer Database (NCDB). Patients were stratified based on HPV status and genotype, with HPV-negative tumors serving as the reference group. Multivariable Cox regression analysis was performed to assess the independent prognostic value of different HPV genotypes.
Th majority of patient were classified as HPV-positive (N = 17,358, 70.0%), with HPV 16 being the most common genotype (N = 15410/17358, 88.8%) compared with other high-risk (N = 1217/17,358, 7.0%) and low-risk (N = 731/17,358, 4.2%) HPV genotypes. A significantly lower risk of death was measured for all HPV-positive compared with HPV-negative tumors (HPV 16: adjusted HR 0.51; 95% CI: 0.49-0.54; other high-risk HPV: adjusted HR 0.56; 95% CI: 0.49-0.63; low-risk HPV: adjusted HR 0.59; 95% CI: 0.50-0.68; p < 0.001).
This study highlights the significant prognostic value of HPV genotypes in OPSCC, underscoring the superior survival outcomes of HPV-positive tumors across all genotypes compared with HPV-negative tumors. Detailed HPV subtype analysis can inform better treatment decisions and support de-intensification strategies for patients with low-risk genotypes.
3 Laryngoscope, 135:695-704, 2025.
由于临床决策越来越依赖人乳头瘤病毒（HPV）状态，口咽鳞状细胞癌（OPSCC）中HPV基因型的预后意义已受到广泛关注。本研究旨在比较OPSCC患者中不同HPV基因型与HPV阴性肿瘤相关的生存结果，为治疗降阶梯策略的潜在影响提供见解。
从国家癌症数据库（NCDB）纳入诊断为浸润性OPSCC的患者。根据HPV状态和基因型对患者进行分层，以HPV阴性肿瘤作为参照组。进行多变量Cox回归分析以评估不同HPV基因型的独立预后价值。
大多数患者被归类为HPV阳性（N = 17358，70.0%），与其他高危（N = 1217/17358，7.0%）和低危（N = 731/17358，4.2%）HPV基因型相比，HPV16是最常见的基因型（N = 15410/17358，88.8%）。与HPV阴性肿瘤相比，所有HPV阳性肿瘤的死亡风险均显著降低（HPV16：调整后HR 0.51；95%CI：0.49 - 0.54；其他高危HPV：调整后HR 0.56；95%CI：0.49 - 0.63；低危HPV：调整后HR 0.59；95%CI：0.50 - 0.68；p < 0.001）。
本研究强调了HPV基因型在OPSCC中的重要预后价值，强调了与HPV阴性肿瘤相比，所有基因型的HPV阳性肿瘤具有更好的生存结果。详细的HPV亚型分析可为更好的治疗决策提供依据，并支持低危基因型患者的降阶梯策略。
3 喉镜，135:695 - 704，2025年。
