Human Papillomavirus Infection and Survival in Oral Squamous Cell Cancer: A Population‐Based Study

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Abstract
OBJECTIVE: To determine whether human papillomavirus (HPV) type 16 affects survival in oral squamous cell carcinoma.STUDY DESIGN: Two hundred fifty‐four patients diagnosed with primary oral cancer were studied for survival in relation to tumor HPV type 16 status. Kaplan‐Meier analysis and Cox proportional hazard models were used to assess survival and estimate hazard ratios adjusted for potential confounders.RESULTS: HPV type 16 DNA was detected in 15.1% of tumors. HPV 16 positive patients had significantly reduced all‐cause mortality (hazard ratio [HR] estimates = 0.34, 95% CI = 0.14, 0.83) and disease‐specific mortality (HR = 0.17, 95% CI = 0.04, 0.76) compared with HPV 16 negative patients after adjustment for age, stage, treatment, smoking, alcohol, education, and comorbid disease.CONCLUSIONS: The presence of HPV type 16 DNA is independently associated with a favorable prognosis in patients with oral squamous cell carcinoma.CLINICAL SIGNIFICANCE: Although HPV genotyping is currently not widely available, it may provide important prognostic information.