Role of human papillomavirus in laryngeal squamous cell carcinoma: A meta-analysis of cohort study

Abstract

Objective: To evaluate the association of human papilloma virus (HPV) infection with prognosis, specifically overall survival (OS) and disease-free survival (DFS), in laryngeal squamous cell carcinoma (LSCC) patients. Method: A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. LSCC was confirmed on the basis of histopathology, whereas HPV status was confirmed by polymerase chain reaction. Results: A total of 6539 articles were initially searched from 8 databases, of which 11 studies were eligible for our review. A total of 1442 LSCC cases were included in this analysis. Eight studies examined 3-year OS for LSCC. The pooled hazard ratio (HR) from the 8 studies was 0.29 (95% CI: 0.25-0.33). There was a statistically significant difference in 3-year OS between the HPV-negative and -positive groups, with the latter having a better survival. There was no statistically significant differences in 5- and 10-year OS. Five studies examined 3- and 5-year DFS for LSCC, whereas only 3 studies examined 10-year DFS. There was no statistically significant difference in 3-, 5-, and 10-year DFS between the HPV groups. Conclusion: This study evaluated the survival impact of HPV infection in LSCC patients. The OS of the HPV-positive group was better than that of the HPV-negative group in terms of short-term survival. Compared with the HPV-negative group, the HPV-positive group had a better trend of DFS, suggesting that a larger sample size and further exploration of the pathology and local control of HPV-positive tumors are needed.