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Correlation of human papillomavirus infection and clinical parameters with five-year survival in oral squamous cell carcinoma

  • S M Adnan Ali (a1), M S Awan (a1), S Atif (a2), N Ali (a2) and Y Mirza (a1)...



This study associated Human Papillomavirus (HPV) infection and other clinical parameters with five-year survival of oral squamous cell carcinoma patients at a tertiary care hospital in Karachi, Pakistan.


A total of 140 patients diagnosed with oral squamous cell carcinoma were enlisted. HPV status and subtypes were established through polymerase chain reaction performed in a previously published study. Clinical data including five-year survival were obtained through institutional medical records.


Ninety-five patients (67.9 per cent) were positive for HPV. Of these, 85 patients were HPV 16 positive while 2 patients were HPV 18 positive. The mean survival time for HPV positive patients was 44.3 months, whereas survival time for HPV negative patients was 46.9 months. Univariate analysis showed that HPV status in oral squamous cell carcinoma was not a statistically significant factor in determining five-year survival rate (p = 0.386).


There is a high prevalence of HPV positive oral squamous cell carcinoma in Pakistan; however, there is no difference in the five-year survival rate when compared to HPV negative oral squamous cell carcinoma.


Corresponding author

Address for correspondence: Dr S M Adnan Ali, Office of Academia and Research in Surgery, Department of Surgery, Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi 74800, Pakistan Fax: +92 21 3493 4294 E-mail:


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Dr S M Adnan Ali takes responsibility for the integrity of the content of the paper



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1GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. In: [6 January 2017]
2Markopoulos, AK. Current aspects on oral squamous cell carcinoma. Open Dent J 2012;6:126–30
3de Camargo Cancela, M, Voti, L, Guerra-Yi, M, Chapuis, F, Mazuir, M, Curado, MP. Oral cavity cancer in developed and in developing countries: population-based incidence. Head Neck 2010;32:357–67
4Pytynia, KB, Dahlstrom, KR, Sturgis, EM. Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol 2014;50:380–6
5Psyrri, A, DiMaio, D. Human papillomavirus in cervical and head-and-neck cancer. Nat Clin Prac Oncol 2008;5:2431
6Mork, J, Lie, AK, Glattre, E, Hallmans, G, Jellum, E, Koskela, P et al. Human papillomavirus infection as a risk factor for squamous-cell carcinoma of the head and neck. N Engl J Med 2001;344:1125–31
7Chaturvedi, AK, Engels, EA, Pfeiffer, RM, Hernandez, BY, Xiao, W, Kim, E et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011;29:4294–301
8Dayyani, F, Etzel, CJ, Liu, M, Ho, CH, Lippman, SM, Tsao, AS. Meta-analysis of the impact of human papillomavirus (HPV) on cancer risk and overall survival in head and neck squamous cell carcinomas (HNSCC). Head Neck Oncol 2010;2:15
9Chung, CH, Gillison, ML. Human papillomavirus in head and neck cancer: its role in pathogenesis and clinical implications. Clin Cancer Res 2009;15:6758–62
10Ang, KK, Harris, J, Wheeler, R, Weber, R, Rosenthal, DI, Nguyen-Tan, PF et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010;363:2435
11Ali, SM, Awan, MS, Ghaffar, S, Salahuddin, I, Khan, S, Mehraj, V et al. Human papillomavirus infection in oral squamous cell carcinomas: correlation with histologic variables and survival outcome in a high risk population. Oral Surgery 2008;1:96105
12Umudum, H, Rezanko, T, Dag, F, Dogruluk, T. Human papillomavirus genome detection by in situ hybridization in fine-needle aspirates of metastatic lesions from head and neck squamous cell carcinomas. Cancer Cytopathol 2005;105:171–7
13Gillison, ML, Koch, WM, Capone, RB, Spafford, M, Westra, WH, Wu, L et al. Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 2000;92:709–20
14Tural, D, Elicin, O, Batur, S, Arslan, D, Oz, B, Serdengecti, S et al. Human papillomavirus is independent prognostic factor on outcome of oropharyngeal squamous cell carcinoma. Tumour Biol 2013;34:3363–9
15Benson, E, Li, R, Eisele, D, Fakhry, C. The clinical impact of HPV tumor status upon head and neck squamous cell carcinomas. Oral Oncol 2014;50:565–74
16Ritchie, JM, Smith, EM, Summersgill, KF, Hoffman, HT, Wang, D, Klussmann, JP et al. Human papillomavirus infection as a prognostic factor in carcinomas of the oral cavity and oropharynx. Int J Cancer 2003;104:336–44.
17Krüger, M, Pabst, AM, Walter, C, Sagheb, K, Günther, C, Blatt, S et al. The prevalence of human papilloma virus (HPV) infections in oral squamous cell carcinomas: a retrospective analysis of 88 patients and literature overview. J Craniomaxillofac Surg 2014;42:1506–14
18Zivile, G, Janina, D, Irina, M, Saulius, C, Raisa, S, Aliaksandr, Z. Prevalence of human papillomaviruses in patients with head and neck squamous cell carcinoma in Lithuania and Belarus. J Med Virol 2014;86:531–5
19Al-Rajhi, N, Khafaga, Y, El-Husseiny, J, Saleem, M, Mourad, W, Al-Otieschan, A et al. Early stage carcinoma of oral tongue: prognostic factors for local control and survival. Oral Oncol 2000;36:508–14
20Bryne, M, Koppang, HS, Lilleng, R, Kjaerheim, A. Malignancy grading of the deep invasive margins of oral squamous cell carcinomas has high prognostic value. J Pathol 1992;166:375–81
21Piccirillo, JF, Lacy, PD, Basu, A, Spitznagel, EL. Development of a new head and neck cancer-specific comorbidity index. Arch Otolaryngol Head Neck Surg 2002;128:1172–9
22Ribeiro, K, Kowalski, L, Latorre, M. Impact of comorbidity, symptoms, and patients’ characteristics on the prognosis of oral carcinomas. Arch Otolaryngol Head Neck Surg 2000;126:1079–85
23Ferlito, A, Rinaldo, A, Thomas Robbins, K, René Leemans, C, Shah, JP, Shaha, AR et al. Changing concepts in the surgical management of the cervical node metastasis. Oral Oncol 2003;39:429–35
24Greenberg, JS, El Naggar, AK, Mo, V, Roberts, D, Myers, JN. Disparity in pathologic and clinical lymph node staging in oral tongue carcinoma. Implication for therapeutic decision making. Cancer 2003;98:508–15
25Shingaki, S, Takada, M, Sasai, K, Bibi, R, Kobayashi, T, Nomura, T et al. Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 2003;185:278–84
26Woolgar, JA, Rogers, SN, Lowe, D, Brown, JS, Vaughan, ED. Cervical lymph node metastasis in oral cancer: the importance of even microscopic extracapsular spread. Oral Oncol 2003;39:130–7
27Greenberg, JS, Fowler, R, Gomez, J, Mo, V, Roberts, D, El Naggar, AK et al. Extent of extracapsular spread: a critical prognosticator in oral tongue cancer. Cancer 2003;97:1464–70
28Preuss, SF, Klussmann, JP, Semrau, R, Huebbers, C. Update on HPV-induced oropharyngeal cancer [in German]. HNO 2011;59:1031–7
29Fakhry, C, Westra, WH, Li, S, Cmelak, A, Ridge, JA, Pinto, H et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 2008;100:261–9
30Petrelli, F, Sarti, E, Barni, S. Predictive value of human papillomavirus in oropharyngeal carcinoma treated with radiotherapy: an updated systematic review and meta-analysis of 30 trials. Head Neck 2014;36:750–9



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