Long-term prognosis and risk factors among patients with HPV-associated oropharyngeal squamous cell carcinoma

Brian M. Lin, Hao Wang, Gypsyamber D'Souza, Zhe Zhang, Carole Fakhry, Andrew W. Joseph, Virginia E. Drake, Giuseppe Sanguineti, William H. Westra, Sara I. Pai

Research output: Contribution to journalArticlepeer-review


BACKGROUND A subset of patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (HPV-OSCC) experience poor clinical outcomes. The authors of this report explored prognostic risk factors for overall survival (OS) and recurrence-free survival (RFS). METHODS Patients with incident HPV-OSCC who received treatment at the Johns Hopkins Hospital between 1997 and 2008 and who had tissue available for HPV testing as well as demographic and clinicopathologic information (N = 176) were included. Tissue was tested for HPV by in situ hybridization (ISH) and/or p16 immunohistochemistry. Demographic and clinicopathologic information was extracted from medical records. RESULTS In total, 157 of 176 patients (90%) with OSCC had HPV-associated disease (HPV-OSCC). In the patients with HPV-OSCC, the 3-year and 5-year OS rates were 93% (95% confidence interval [CI], 88%-98%) and 89% (95% CI, 81%-97%), respectively. Shorter survival was observed among older patients (hazard ratio [HR], 2.33 per 10-year increase; 95% CI, 1.05-5.16 per 10-year increase; P =.038), patients with advanced clinical T classification (HR, 5.78; 95% CI, 1.60-20.8; P =.007), and patients who were currently using tobacco (HR, 4.38; 95% CI, 1.07-18.0; P =.04). Disease recurrence was associated with advanced clinical T-classification (HR, 8.32; 95% CI, 3.06-23; P

Original languageEnglish
Pages (from-to)3462-3471
Number of pages10
Issue number19
Publication statusPublished - Oct 1 2013


  • head and neck cancer
  • human papillomavirus
  • oropharyngeal cancer
  • risk factors
  • sex

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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