Introduction
Oropharyngeal squamous cell carcinoma (OPSCC) has seen a notable increase in incidence globally, largely attributed to human papillomavirus (HPV) infections. This study focuses on the clinical characteristics and treatment outcomes of OPSCC patients in Shanxi Province, China, examining the influence of HPV status on prognosis and identifying key risk factors.
Study Objective
The primary aim of this research was to explore the clinical features and current treatment landscape of OPSCC patients in Shanxi Province. Additionally, the study sought to understand the relationship between these factors and HPV status, particularly focusing on the prognostic implications of p16 expression, a surrogate marker for HPV.
Methods
A retrospective analysis was conducted on 120 OPSCC patients from two tertiary hospitals in Shanxi Province. The study utilized statistical methods to evaluate the correlation between clinicopathological factors, treatment modalities, and p16 status, and their collective impact on patient prognosis.
Results
The study found that the most common sub-anatomical sites for OPSCC were the tonsils and the base of the tongue, with a higher prevalence of p16-positive cases in these areas (P = 0.033). Poorly differentiated squamous cell carcinoma was predominant (52.5%), with 71.4% of these cases being p16-positive (P = 0.002). Patients with p16-positive OPSCC frequently presented with a neck mass as the initial symptom (73.2%, P = 0.019). Overall, p16-positive patients demonstrated a better prognosis (P = 0.008), although this advantage was not observed in those with primary tumors in the soft palate and posterior pharyngeal wall.
Discussion
The incidence of HPV-associated OPSCC in Shanxi Province has surpassed that of OPSCC linked to smoking and alcohol use. Despite the generally favorable prognosis for p16-positive patients, those with tumors in the soft palate and posterior pharyngeal wall did not exhibit significant prognostic benefits. Surgical treatment did not improve survival rates, particularly in the p16-positive group, where non-surgical treatment showed better outcomes approximately one year post-treatment.
Conclusion
In Shanxi Province, HPV-related OPSCC has become more prevalent than OPSCC caused by traditional risk factors like smoking and alcohol. The study highlights that not all HPV-positive OPSCC cases have a favorable prognosis, especially for tumors located in the soft palate and posterior pharyngeal wall. This suggests that treatment de-escalation should be approached cautiously. Traditional open surgical treatments, irrespective of HPV status, do not appear to benefit patients.
Global Context and Implications
Globally, the incidence of HPV-OPSCC has been rising, with significant variations in HPV infection rates across different regions. The American Joint Committee on Cancer (AJCC) has incorporated HPV tumor status into its staging system, reflecting the better prognosis associated with HPV-OPSCC. However, not all cases exhibit favorable outcomes, with some experiencing recurrence or metastasis post-treatment.
Study Limitations and Future Directions
This study’s retrospective nature and relatively small sample size, particularly for patients with tumors in the soft palate or posterior pharyngeal wall, may introduce selection bias. Future research should involve larger, multi-center studies with extended follow-up periods and include quality of life assessments post-treatment.
Ethical Considerations
The study was approved by the Ethics Committee of Shanxi Hospital and conducted in accordance with local legislation and institutional requirements. As a retrospective, non-interventional study, it did not require written informed consent from participants.
Conclusion
This research underscores the unique clinical and biological characteristics of HPV-OPSCC. With the rising incidence of HPV-OPSCC in China, particularly in economically underdeveloped regions like Shanxi, there is a need for tailored treatment strategies that consider HPV status. Identifying biomarkers for poor prognosis in HPV-positive OPSCC will be crucial for developing individualized treatment plans.
🔗 **Fuente:** https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1533688/full