Competing mortality in oropharyngeal carcinoma according to human papillomavirus status

Head Neck. 2019 May;41(5):1328-1334. doi: 10.1002/hed.25559. Epub 2018 Dec 14.


Background: The objective of the present study is to assess differences in the competing causes of death in patients with oropharyngeal carcinoma (OPC) as a function of the human papillomavirus (HPV) status.

Methods: We studied retrospectively 423 patients with OPC with known HPV status. Among the patients included in the study, 53 (12.5%) were HPV-positive. We analyzed overall survival and competing causes of mortality according to the HPV status of the patients.

Results: Patients with HPV-negative tumors had lower OPC cancer-specific survival (P = .0001), second primary neoplasm survival (P = .0001), and noncancer-related causes survival (P = .13) than patients with HPV-positive tumors. This resulted in significant differences in overall survival depending on HPV status (P = .0001).

Conclusion: Conclusion: HPV-positive OPC has a better overall survival than HPV-negative OPC. Patients with HPV-positive tumors presented a significant lower OPC cancer-specific and second primary neoplasm mortality and a marginally nonsignificant lower noncancer mortality as compared to HPV-negative tumors.

Keywords: HPV; competing mortality; head and neck cancer; noncancer-related deaths; oropharyngeal carcinoma; second primary cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cause of Death*
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / mortality*
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / therapy
  • Oropharyngeal Neoplasms / virology*
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / complications*
  • Prognosis
  • Regression Analysis
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck / mortality*
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / therapy
  • Squamous Cell Carcinoma of Head and Neck / virology*
  • Statistics, Nonparametric
  • Survival Analysis