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Background: Oropharyngeal squamous cell carcinoma (OPSCC) positive for human papillomavirus (HPV) increases wolrd wide., Aims/objectives: The objective for this study has been to evaluate tumor phenotypes and tumor host responses with respect to five-year disease-specific survival (DSS) in HPV(+) and HPV(-) patients., Material and Methods: Two hundred patients with OPSCC have been treated between 1992 and 2010. Histopathology slides from these patients have been morphologically evaluated in formalin-fixed, paraffin-embedded (FFPE) stained with hematoxylin-eosin (HE). From HE-stained sections tumor phenotype (keratinization, fraction of mature cancer cells and pattern of invasion) and tumor host responses (inflammation and stromal desmoplasia) were evaluated with respect to five years DSS., Results: High tumor inflammatory response and low stromal desmoplasia had an independent effect predicting better five-year DSS among all patients and when analyzed separately in the HPV(-) and HPV(+) cohort of patients using a Cox regression survival analysis that also included standard clinical prognostic variables among OPSCC patients., Conclusion: Tumor host responses, inflammation and stromal desmoplasia may become part of routine work-up in OPSCC patients due to prognostic value., Significance: We present a method, accessible in most clinical locations and would give important additional information about prognosis in OPSCC patients.

Conclusions: Patients with human papillomavirus (HPV)-positive tumours had better 5-year disease-specific survival (DSS) than HPV-negative patients. TNM score only predicted prognosis among HPV-negative patients. A previous history of smoking and age at diagnosis predicted DSS among HPV-positive patients whereas operability at diagnosis predicted DSS among both HPV-positive and HPV-negative patients., Objectives: HPV is a risk factor for oropharyngeal squamous cell carcinoma (OPSCC). The extent to which smoking, age and operability could play a role in HPV-positive surgically treated head and neck SCCs has not been extensively addressed previously and this study aimed to evaluate these factors., Methods: We identified 232 patients with OPSCC, of which 186 from the tonsil or base of the tongue region were treated in the period 1992-2008 in Western Norway. The 5-year DSS was recorded. Details on smoking history and whether the lesion was operable or not, as well as clinical information, were obtained retrospectively from the hospital records., Results: TNM stage predicted survival only among HPV-negative patients. A previous smoking affected prognosis only among HPV-positive patients (relative risk (RR) = 2.5; confidence interval (CI) = 1.0-6.2; p = 0.05). Increasing age of the patient had a negative effect on survival in HPV-positive patients only, especially among the oldest quartile (RR = 4.4; CI = 2.0-9.0; p < 0.001). Whether the tumour was operable or not uniquely predicted DSS both among HPV-positive (RR = 0.34; CI = 0.13-0.93; p < 0.05) and HPV-negative (RR = 0.25; CI = 0.10-0.66; p < 0.01) patients with tonsil/base of the tongue SCC.

Conclusions: We determined that 55% of the patients with oropharynx squamous cell carcinoma (OPSCC) had human papilloma virus (HPV)-positive tumors. We demonstrated that HPV-positive patients had better 5-year disease-specific survival (DSS) than the HPV-negative counterparts. This was also primarily true for cancers originating in the tonsil or base of the tongue with T3 and/or N2 tumors., Objective: Urogenital high risk (hr) HPV is an important risk factor, and probably causative agent, for OPSCC. The study investigated these factors., Methods: We identified 232 patients with OPSCC, of which 186 lesions were from the tonsil or base of the tongue region, treated in the period 1992-2008 in Western Norway. Five-year DSS was recorded for all patients., Results: In all, 124 of 226 patients had HPV-positive tumors. All except five HPV-positive patients had HPV-16-positive tumors; 69% of the patients with tonsil or base of the tongue SCC had HPV-positive tumors, whereas 14% of remaining OPSCC patients had HPV-positive tumors. Five-year DSS with HPV-positive tumor was 77% compared with 53% with an HPV-negative tumor (p < 0.001), also valid with adjustment for age, gender, and TNM stage, but primarily determined with patients with the specific tumor sites tonsils and base of the tongue with TNM stages T3 or N2.