Association of human papillomavirus (HPV) infection with the occurrence of second neoplasms and their prognostic impact in patients with oropharyngeal carcinoma.

Introduction: This study analyses the incidence of second neoplasms in patients with oropharyngeal carcinoma according to human papillomavirus (HPV) status and its impact on survival.

Material and methods: A retrospective analysis of 583 patients with oropharyngeal cancer treated between 1991 and 2023 was performed. A total of 112 patients (19.2%) had HPV-positive tumours.

Results: During the follow-up, 181 patients (31.0%) had a second neoplasm. The 5-year and 10-year second neoplasm-free survival for HPV-negative patients were 60.5% and 37.5%, significantly lower than in HPV-positive patients, which were 88.2% and 70.8%, respectively (p = .0001). The 84.4% of second and subsequent neoplasms in HPV-negative patients occurred in locations associated with tobacco and alcohol use, compared to 65.5% in HPV-positive patients (p = .001). In comparison to HPV-positive patients with no history of toxics consumption, HPV-positive patients with severe toxics consumption had a significantly higher risk of second neoplasms in locations associated with tobacco and alcohol use (p = .003). The competitive mortality associated with the appearance of second and subsequent neoplasms was significantly higher for patients with HPV-negative tumours (p = .0001).

Conclusions: Patients with HPV-positive oropharyngeal carcinomas have a lower risk of second neoplasms and lower competitive mortality associated with the appearance of second neoplasms compared with HPV-negative patients.