The current controversial discussion of the link between disease-specific survival of HPV positive and negative patients with head and neck squamous cell carcinoma (HNSCC) was crucial in carrying out this meta-analysis.
Our experimental study on HPV diagnostics on oral squamous cell carcinoma (OSCC) showed that unequal, inhomogeneous patient collectives are compared with each other in the assessment of the influence of the HPV status on the survival of patients (1). Furthermore, insufficient detection methods of HPV are still used. A false interpretation of survival rates and the impact of HPV is the consequence.
170 studies from 2007 to 2014 (NCBI / Pubmed) were evaluated in this meta-analysis. Exclusion criteria were patient groups with n <70. The HPV detection method, patient characteristics (age, sex), tumor location and stadia, (neo-) adjuvant therapy measures and survival times were recorded and evaluated.
The analysis showed that the survival times in many studies were not evaluated in a multifactorial manner, since important confounders were ignored. The analyzed HPV detection methods were often not sufficient to represent HPV infection. Moreover, in a variety of studies, oropharyngeal and oral squamous cell carcinomas were evaluated as one cohort. With regard to the different survival rates of the affected patients of these cancers of different anatomical regions a subdivison of anatomical regions is indispensable. Studies of OSCC, that took care about the latter points did not show any improved survival of the HPV-positive collectives.
The results of the experimental study of our research group were confirmed by our metaanlysis (1). The discussion about a revision of therapy strategies of OSCC dependent of the HPV status must be rejected according to current knowledge. Studies published so far have to be questioned very critically and are not a sufficient for therapeutic decisions.
(1) Impact of HPV infection on oral squamous cell carcinoma.
Götz C, Drecoll E, Straub M, Bissinger O, Wolff KD, Kolk A.
Oncotarget. 2016 Nov 22;7(47):76704-76712. doi: 10.18632/oncotarget.12501.