Mouth Cancer Prognosis Improves When Cervical Cancer Virus Involved
Finding HPV in tumor meant lower death rates in those with cancer at back of the mouth, study finds
For patients battling a type of cancer that affects the back of the mouth, the chances of survival increase if the tumor contains the sexually transmitted virus that causes cervical cancer, new research shows.
In fact, the presence of human papillomavirus (HPV) is the most important predictor of survival in oropharyngeal cancer, researchers from the Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James) found.
"Previous studies indicated a relationship existed between the presence or absence of HPV in oropharyngeal tumors and patient survival, but they couldn't determine if other favorable factors present in these patients were responsible for their better outcome," lead author Dr. Maura Gillison, an OSUCCC-James medical oncologist and head and neck cancer specialist, said in a news release.
"These findings close the door on these questions," Gillison added, "and will allow the field to move forward with clinical trials designed to determine how we should use molecular and behavioral factors to personalize therapy for patients."
The report was published online June 7 in the New England Journal of Medicine, to coincide with presentation of the findings Monday at the American Society of Clinical Oncology annual meeting, in Chicago.
The authors noted that a patient's lifetime smoking history was the second leading predictor of survival for this particular form of cancer.
The finding stems from a three-year post-treatment analysis of tumors and survival rates among 323 patients diagnosed with stage 3 or stage 4 oropharyngeal cancer, among whom 206 had HPV-positive tumors while 117 had HPV-negative tumors.
More than 80 percent of those with HPV-positive tumors remained alive three years after treatment, the authors found, while the same was true for just 57 percent of those with HPV-negative tumors.
Other potential factors -- such as being younger, being white, having more energy, lacking anemia, and/or having a smaller tumor size -- accounted for just 10 percent of the survival rate differences, the team concluded.
On the other hand, smoking did register as a serious risk factor for poor survival chances, for both HPV-positive and HPV-negative patients, the study found. In fact, the risk for dying from the disease or experiencing a relapse rose 1 percent for every year that patients had smoked one pack per day.
The study authors said more research is needed before being able to discern exactly how doctors might best make use of such survival factor information when designing a patient's treatment plan. However, knowing a patient's HPV status and smoking history should be considered central --alongside knowing what stage the patient's cancer is at -- to any decision-making process regarding which treatment strategy to utilize and how aggressively it should be administered, the authors noted.
More information
For more on oropharyngeal cancer, visit the U.S. National Cancer Institute.
-- Alan Mozes
SOURCE: Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, news release, June 7, 2010
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