Oral health in HPV-positive and HPV-negative patients with oropharyngeal squamous cell carcinoma

Philipp Kanzow; Katharina Mielke; Valentina Hrasky; Susanne Wiegand; Henning Schliephake; Dirk Beutner; Annette Wiegand

doi:10.3389/fonc.2023.1083067

Oral health in HPV-positive and HPV-negative patients with oropharyngeal squamous cell carcinoma

Front Oncol. 2023 Jan 26:13:1083067. doi: 10.3389/fonc.2023.1083067. eCollection 2023.

Authors

Philipp Kanzow¹, Katharina Mielke¹, Valentina Hrasky¹, Susanne Wiegand², Henning Schliephake³, Dirk Beutner⁴, Annette Wiegand¹

Affiliations

¹ Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany.
² Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany.
³ Department of Oral and Maxillofacial Surgery, University Medical Center Göttingen, Göttingen, Germany.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany.

Abstract

This study compared oral health in oropharyngeal squamous cell carcinoma (OPSCC) patients with positive or negative human papillomavirus (HPV) status and analysed whether oral health was associated with survival. Patients referred for dental assessment prior to radio(chemo)therapy between 2009 and 2019 were included. Patient-related risk factors for OPSCC (alcohol, tobacco, HPV status), age, sex, treatment (primary treatment, intent), performance status, tumor/node/metastasis (TNM) staging, and oral health parameters (DMFT, periodontal status, teeth with/without root canal treatment and with/without periodontitis apicalis) were compared between HPV-negative and HPV-positive patients. Survival was assessed using Kaplan-Meier statistics. The effect of patient-related risk factors and oral health parameters was analysed by cox regression analyses (α=5%). A total of 119 patients (n=50 HPV-negative, n=69 HPV-positive) was included. HPV-positive patients showed more present teeth, a higher number of filled teeth, were less often edentulous and presented a lower DMFT compared to HPV-negative patients (p_adj.≤0.003). Among dentulous patients, HPV-positive patients showed more present teeth and fewer teeth with periodontitis apicalis lacking a root canal treatment (p_adj.≤0.036). Survival probability differed between groups (p=0.006) and trended towards being associated with HPV status, tobacco exposure, performance status, T stage, N stage, and the number of missing or filled teeth as well as the number of root canal treated teeth with periodontitis apicalis and the number of teeth with periodontitis apicalis lacking a root canal treatment (p≤0.077). However, only tobacco exposure, performance status, and the number of teeth with periodontitis apicalis lacking a root canal treatment in dentulous patients remained significant in the multivariate analyses (p≤0.047). HPV-negative patients with OPSCC showed a poorer oral health compared to HPV-positive patients, but survival was not associated with oral health.

Keywords: HPV; head and neck cancer; head and neck squamous cell carcinomas; oral health; oropharynx cancer; survival.

Grants and funding

The authors acknowledge support by the Open Access Publication Funds of Göttingen University.