Objective: This study was designed to investigate the potentially prognostic indicators of early laryngeal squamous cell carcinomas (LSCCs), including human papillomavirus (HPV) status.
Methods: A total of 336 patients with T2N0-1M0 LSCC were included in this study. Clinical data were collected from archival documents, and HPV infection and p16(INK4A) expression were detected.
Results: A total of 32/318 cases of high-risk HPV infection and 10/336 cases of p16(INK4A) overexpression were found. Three hundred eighteen tumors were classified into a three-class model according to HPV infection and p16(INK4A) expression: class I, HPV+/p16+; class II, HPV+/p16-; and class III, HPV-/p16-. Class III had a trend of decreased overall survival (OS) (P = 0.076) and a markedly low relapse-free survival (RFS) (P = 0.022) compared with class I and class II. HPV-positive cases (class I plus class II) had a significantly longer OS (P = 0.038) and RFS (P = 0.006). In multivariate analysis, HPV-positive (P = 0.020), nonanemia (P = 0.011), and N0 stage (P = 0.005) were significant predictors for high RFS. But only HPV-positive (P = 0.047) and nonanemia (P < 0.001) were significant predictors for superior OS.
Conclusion: A trend of discrete survival among HPV+/p16+, HPV+/p16-, and HPV-/p16 classes was found in early LSCCs. We suggest that HPV infection and hemoglobin level are the potential factors that can stratify outcome of early LSCCs.
Keywords: Hemoglobin; Human papillomavirus; Laryngeal SCC; N1 stage; p16(INK4A).
Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.