Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Background: Oral cavity cancer (OCC) is a major global health concern, with varying risk factors influencing its pathogenesis. One significant factor implicated in the etiology of certain head and neck cancers is human papillomavirus (HPV) infection, yet its role in oral cavity cancer remains less understood compared to oropharyngeal cancers. This systematic review and meta-analysis aim to assess the prevalence of HPV infection in oral cavity cancer, identify prevalent HPV genotypes, and characterize the association between HPV status and clinical outcomes.
Methods: A systematic review of the literature was conducted, following PRISMA guidelines, to identify studies reporting HPV prevalence, genotyping data, and characterization of HPV status in patients diagnosed with oral cavity cancer. Databases such as PubMed, Embase, and Scopus were searched from inception to August 17,2024. Meta-analysis was performed to estimate pooled HPV prevalence in OCC across various geographical regions and subgroups. Secondary outcomes included identifying the distribution of high-risk HPV genotypes, particularly HPV16 and HPV18, and assessing the association of HPV positivity with survival rates, tumor differentiation, and treatment outcomes.
Results: A total of 240 studies encompassing 250,000 patients were included in the analysis. The pooled prevalence of HPV in OCC was estimated to be (18%,95%:4-16) with significant variation across different geographic regions. Genotyping data revealed that HPV16 was the predominant strain, followed by HPV18, accounting for [63%, 95% 1-3] and [37%, 95% 3-6] of the cases, respectively. The analysis demonstrated a significant association between HPV-positive status and improved survival outcomes, including higher overall survival and disease-free survival rates, compared to HPV-negative cases. Additionally, HPV-positive tumors tended to present with better differentiation and lower rates of local recurrence.
Conclusion: This systematic review and meta-analysis highlight that while HPV infection is less prevalent in oral cavity cancer compared to oropharyngeal cancer, its presence—particularly HPV16—is associated with favorable clinical outcomes. The findings suggest the need for further research into the role of HPV as a prognostic marker and the potential for HPV-targeted therapies in oral cavity cancer management