The association between HPV and prognosis of carcinoma of unknown primary in the head and neck region: A systematic review and metaanalysis
Wen Yang, Jianjun Ren, Jie Su, Xue Ren, Rouhi Fazelzad, Yu Zhao, Wei Xu and Geoffrey Liu
Sichuan University, China
Princess Margaret Cancer Centre, Canada
Shanghai University of Finance and Economics, China
University Health Network, Canada
University of Toronto, Canada
: J Otol Rhinol
Abstract
Aim: As it has been postulated that the majority of cancer of unknown primary in head and neck region (CUPHN) is likely to originate from the oropharynx, where human papillomavirus (HPV) is a known risk and prognostic factor; we aimed to compare the prevalence and outcome prognosis of HPV-positive CUPHN patients with HPV-negative CUPHN patients. Methods: Medline, Epub ahead of print, in-process and other nonindexed citations, EMBASE, Cochrane Library and Web of Science were searched in this study, without Language restriction. Studies were limited to observational studies and clinical trials that reported on the survival rates of patients with CUPHN which presented as HPV positive vs. HPV negative. Additionally, matched oropharyngeal cancer (OPC) studies from the same institution each included CUPHN study were searched to compare the HPV prevalence in CUPHN and OPC. Results: Seventeen studies with overall survival (OS) and progression-free survival (PFS) data were included in this study, and seventeen institution-matched OPC studies were presented in the comparison of HPV prevalence. The pooled results show that CUPHN patients with HPV positive status presented to have a favorable OS and PFS prognosis when compared to those HPV negative patients. The HPV prevalence rates between CUPHN and OPC patients (institution-matched) were quite similar, with difference to be only 12% (p<0.00001). Conclusion: Results suggest that CUPHN tend to have a similar HPV-related prevalence and prognosis with OPC, indicating that HPV may be a favorable maker to predict outcomes for CUPHN patients, or even provide clues to detect their potential primaries to help guiding treatments.
Biography
Wen Yang currently pursuing MD in the Department of Otorhinolaryngology, West China Hospital, West China Medical School at Sichuan University. His research is on common diseases in the Department of ENT, especially etiology, diagnosis and treatment of children OSA and head and neck cancer. He is taking part in a multicenter prospective clinical study about curative effect of CSOM.
E-mail: 2808878554@qq.com
