Background: Tobacco or human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) represent different clinical and epidemiologic entities. This study investigated the prevalence of HPV-positive and HPV-negative OPSCC in a reference cancer hospital in Brazil and its association with clinical and demographic data, as well as its impact on overall survival. Methods: HPV infection was determined by p16-IHC in pre-treatment formalin-fixed paraffin-embedded samples from all patients with OPSCC diagnosed at Barretos Cancer Hospital between 2008 and 2018. The prevalence of HPV-positive cases and its temporal trend was assessed, and the association of clinical and demographic data with HPV infection and the impact on patient overall survival was evaluated. Results: A total of 797 patients with OPSCC were included in the study. The prevalence of HPV-associated tumors in the period was 20.6% [95% confidence interval, 17.5–24.0] with a significant trend for increase of HPV-positive cases over the years (annual percentage change = 12.87). In a multivariate analysis, the variables gender, level of education, smoking, tumor sublocation, region of Brazil, and tumor staging had a significant impact in HPV positivity, and a greater overall survival (OS) was observed in HPV-positive patients (5-year OS: 47.9% vs. 22.0%; P = 0.0001). Conclusions: This study represents the largest cohort of Brazilian patients with OPSCC characterized according to HPV status. We report significant differences in demographics and clinical presentation according to HPV status, and an increasing trend in prevalence for HPV-induced tumors. Impact: These findings can potentially contribute to a better stratification and management of patients as well as assist in prevention strategies.

中文翻译：

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巴西 HPV 诱发的口咽鳞状细胞癌：患病率、趋势、临床和流行病学特征

背景：烟草或人乳头瘤病毒 (HPV) 相关的口咽鳞状细胞癌 (OPSCC) 代表不同的临床和流行病学实体。本研究调查了巴西一家参考癌症医院中​​ HPV 阳性和 HPV 阴性 OPSCC 的患病率及其与临床和人口统计数据的关联，以及其对总生存期的影响。方法：采用 p16-IHC 检测 2008 年至 2018 年间在 Barretos 癌症医院诊断的所有 OPSCC 患者的治疗前福尔马林固定石蜡包埋样本中的 HPV 感染情况。评估 HPV 阳性病例的患病率及其时间趋势，并评估了临床和人口统计数据与 HPV 感染的关联以及对患者总生存期的影响。结果：共有 797 名 OPSCC 患者被纳入研究。在此期间 HPV 相关肿瘤的患病率为 20.6% [95% 置信区间，17.5-24.0]，多年来 HPV 阳性病例呈显着增加趋势（年变化百分比 = 12.87）。在多变量分析中，变量性别、教育水平、吸烟、肿瘤亚位、巴西地区和肿瘤分期对 HPV 阳性有显着影响，在 HPV 阳性患者中观察到更高的总生存期 (OS) (5年 OS：47.9% 对 22.0%；P = 0.0001）。结论：这项研究代表了巴西最大的 OPSCC 患者队列，根据 HPV 状态进行了表征。我们报告了根据 HPV 状态的人口统计学和临床​​表现的显着差异，以及 HPV 诱导的肿瘤患病率的增加趋势。影响：