Incidence of human papillomavirus-related oropharyngeal cancer and outcomes after chemoradiation in a population of heavy smokers

Head Neck. 2014 Jun;36(6):782-6. doi: 10.1002/hed.23366. Epub 2013 Jul 30.


Background: Incidence of human papillomavirus (HPV)-related oropharyngeal carcinomas is increasing worldwide. The purpose of this study was to report the incidence in our region, and to determine the influence of HPV status on survival among a heavy smoking population.

Methods: p16 expression was analyzed in 102 patients with stage II to IV treated with chemoradiation. Overall survival (OS), locoregional control, and disease-free survival (DFS) were compared for HPV+ and HPV- status.

Results: The majority of patients were smokers (86%). p16 positivity was found in 26.7%. Patients who were HPV+ were younger (56 vs 59 years old; p = .052). No differences were observed regarding tumor stage, sex, or smoking between HPV+ and HPV-. Three-year OS was 67.4% for patients who were HPV+ versus 49.7% for HPV- (hazard ratio [HR], 0.55; p = .095).

Conclusion: Incidence of HPV-related oropharyngeal carcinoma in Spain is similar to that reported in other European countries. In this sample of heavy smokers, we observed a nonsignificant trend for better outcomes in patients who were HPV+.

Keywords: chemoradiation; human papillomavirus; incidence; oropharyngeal cancer; smoking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chemoradiotherapy, Adjuvant* / methods
  • Female
  • Human papillomavirus 16 / isolation & purification*
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neck Dissection / methods
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / epidemiology
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / therapy*
  • Oropharyngeal Neoplasms / virology*
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Spain / epidemiology