Findings from a Malaysian multicentre study on oropharyngeal squamous cell carcinoma

• Published in: Infectious Agents and Cancer
• Main Author: Sathasivam H.P.; Davan S.P.; Chua S.M.; Rohaizat R.F.; Japar R.; Zakaria Z.; Ahmad A.R.; Hashim H.; Marimuthu S.G.; Liew Y.T.; Yong D.J.; Vairavan P.; Mohan Singh A.S.; Goh B.H.B.; Yusof Z.; Abu Dahari K.A.S.; Haron A.; Mansor M.; Ibrahim M.Z.; Muhammad Abdul Kadar S.Q.; Hamal M.H.; Wan Mohamad W.E.
• Format: Article
• Language: English
• Published: BioMed Central Ltd 2023
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85178003719&doi=10.1186%2fs13027-023-00557-0&partnerID=40&md5=30f4491e115512e95fa85feedda7a419
• ISSN: 17509378
• DOI: 10.1186/s13027-023-00557-0

Background: In addition to the conventional aetiologic agents of oropharyngeal squamous cell carcinoma (OPSCC) such as tobacco usage, alcohol consumption and betel quid usage, it has been established that a proportion of OPSCC are driven by persistent oncogenic human papillomavirus (HPV) infections. Currently, there is a lack of data on the burden of HPV- associated OPSCC in Asian countries including Malaysia. Methods: A cross-sectional multicentre study with tissue analysis of Malaysian patients diagnosed with primary OPSCC within a five-year period, from 2015 to 2019 between 01/01/2015 to 31/12/2019 was undertaken. Determination of HPV status was carried out using p16INK4a immunohistochemistry on tissue microarrays constructed from archived formalin-fixed paraffin-embedded tissue. Results: From the cases identified, 184 cases had sufficient tissue material for analysis. Overall, median age at diagnosis was 63.0 years (IQR = 15) and 76.1% of patients were males. In our cohort, 35.3% of patients were Indian, 34.2% were Chinese, 21.2% were Malay and 9.2% were from other ethnicities. The estimated prevalence of HPV-associated OPSCC in our cohort was 31.0% (CI 24.4–38.2%). The median age for the HPV-associated OPSCC sub-group of patients was not significantly lower than the median age of patients with HPV-independent OPSCC. More than half of HPV-associated OPSCC was seen in patients of Chinese ethnicity (54.4%). Patients with HPV-associated OPSCC had a much better overall survival than patients with HPV-independent OPSCC (Log rank test; p < 0.001). Patients with HPV-associated OPSCC with no habit-related risk factors such as smoking, were found to have much better overall survival when compared to all other sub-groups. Conclusions: The findings from our study suggests that prevalence of HPV-associated OPSCC in Malaysia, though not as high as some developed countries, is however on an upward trend. HPV-associated OPSCC appears to be more frequently encountered in patients of Chinese ethnicity. Conventional risk-factors associated with OPSCC such as smoking, alcohol consumption and betel quid chewing should still be considered when estimating prognosis of patients with HPV-associated OPSCC. © 2023, The Author(s).