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.