Background: The purpose of this study was to compare outcomes between human papillomavirus (HPV)-related versus -unrelated head and neck cancer after pathological positive planned neck dissection.
Methods: Positive planned neck dissection for head and neck cancers from 1998 to 2010 were included in this study. Outcomes after planned neck dissection were compared between HPV-related versus -unrelated cohorts. Multivariate analysis identified survival predictors.
Results: HPV-related head and neck cancer (n = 32) had better 5-year overall survival (48% vs 27%; p = .021), marginally lower second malignancy (7% vs 16%; p = .13), but similar local, regional, and distant control (87% vs 89%; 94% vs 89%; 62% vs 58%, respectively) versus HPV unrelated (n = 38). HPV status conferred reduced risk of death (hazard ratio [HR], 0.5; p = .038) after adjusting for age, smoking, and initial T and N classifications.
Conclusion: This study reveals that positive planned neck dissection for HPV-related head and neck cancer represents a biologic unfavorable subset of the HPV population with unsatisfactory survival attributable to distant metastasis. The longer survival compared to the HPV-unrelated counterpart is likely related to a marginally lower second malignancy rather than better disease control.
Keywords: head and neck cancer; human papillomavirus; planned neck dissection; radiotherapy; survival.
© 2014 Wiley Periodicals, Inc.