Head and neck squamous cell carcinoma in HIV, HBV and HCV seropositive patients - Prognosis and its predictors
Supreet Singh Nayyar1, Shivakumar Thiagarajan1, Akshat Malik1, Anil D'Cruz1, Devendra Chaukar1, Prachi Patil2, Aruna Dhir Alahari3, Sarbani Ghosh Lashkar4, Kumar Prabhash4
1 Department of Head and Neck Oncology, Tata Memorial Centre, Homibhabha National Institute (HBNI), Mumbai, Maharashtra, India
2 Department of Medical Gastroenterology, Tata Memorial Centre, Homibhabha National Institute (HBNI), Mumbai, Maharashtra, India
3 Department of Medicine, Tata Memorial Centre, Homibhabha National Institute (HBNI), Mumbai, Maharashtra, India
4 Department of Radiation Oncology, Tata Memorial Centre, Homibhabha National Institute (HBNI), Mumbai, Maharashtra, India
Department of Head and Neck Oncology, Tata Memorial Centre, Homibhabha National Institute (HBNI), Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Patients receiving treatment for head-and-neck squamous cell carcinoma (HNSCC) also may have coexisting viral infections caused by HIV, HBV, and HCV (seropositive). There is scarce literature regarding the clinical presentation and treatment outcomes for these patients with coexisting viral infections (seropositive HNSCC). We conducted this study to assess the clinical presentation and treatment outcomes (overall survival [OS] and disease-specific survival [DSS]) of seropositive HNSCC patients.
Methodology: This was a retrospective cohort study on seropositive HNSCC patients registered at our center from 2012 to 2014. The viral infections were identified by the presence of the antibodies to these viruses in the patient's blood samples.
Results: Out of the 19,137 HNSCC patients registered, 156 patients had HBV, HCV, and/or HIV infection. Among these, HBV infection was the most common (n = 86/156, 55.1%) followed by HIV infection (n = 36/156, 23.1%) and HCV infection (n = 29/156, 18.6%). The oral cavity was the most common subsite involved. Majority of these patients presented at an advanced stage (advanced T stage – 71.8% and node positive – 62.2%). The majority of the patients received curative-intent treatment (65.4%). The OS at 3 years for these HNSCC patients with coexisting HIV, HBV, and HCV infection was 60%, 62.6%, and 57.5%, respectively, and their DSS at 3 years was 58.8%, 78.6%, and 53.8%, respectively.
Conclusions: Seropositive patients with HNSCC often present in the advanced stage but have a good survival if treated appropriately.