Survival outcome of tonsillar squamous cell carcinoma (TSCC) in the context of human papillomavirus (HPV): A systematic review and meta-analysis |
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Authors: | Navid Ahmadi Michael Chan Ya Ruth Huo Niranjan Sritharan Ronald Y Chin |
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Institution: | 1. Department of Otolaryngology and Head and Neck Surgery, Nepean Hospital, Sydney, NSW, Australia;2. Department of Radiology, Concord Repatriation General Hospital, Sydney, NSW, Australia;3. University of New South Wales, Sydney, NSW, Australia;4. Western Sydney University, Sydney, NSW, Australia;5. University of Sydney, Sydney, NSW, Australia |
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Abstract: | ObjectiveThe objective of our study was to assess whether HPV-positive TSCC had better survival and prognosis rates, when compared to HPV-negative TSCC.MethodA systematic review and meta-analysis was performed comparing HPV status in TSCC patients. TSCC was confirmed with histopathology and HPV status was confirmed with PCR, immunohistochemistry and/or in-situ-hybridisation. The primary endpoints were overall survival (OS) and disease free survival (DFS).ResultsTwenty-four studies were identified, involving 1921 TSCC cases, of which 56.2% (1079) were HPV positive. OS was significantly higher in patients with HPV-positive compared to HPV-negative TSCC in years 1–5 (OR 2.54, P < 0.01; OR 2.93 P < 0.01; OR 2.74 P < 0.01; OR 2.20 P < 0.01, and OR 2.14 P < 0.01 respectively). Similarly, DFS was also significantly higher in patients with HPV-positive compared to HPV-negative TSCC in years 1–3 (OR 2.86, P < 0.01; OR 2.60 P < 0.02; and OR 2.60 P < 0.01 respectively), which was attenuated in years 4 and 5 (OR 1.83, P = 0.10 and OR 1.50, P = 0.12).ConclusionThis is the largest meta-analysis with 1921 patients, comparing non-HPV induced TSCC and HPV induced TSCC, looking at outcome and survival. HPV-positive had better OS and DFS. |
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Keywords: | Papillomaviridae Tonsillar neoplasms Carcinoma Squamous cell Palatine tonsil Oropharyngeal neoplasms |
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