HPV in the cervix and oropharynx: Assessing the prevalence of gynecologic cancer and precancerous lesions in women with oropharyneal cancer

Presentation: A100
Topic: Oropharynx / HPV Related Disease
Type: Poster
Authors: Austin C Cao, BA; Erin R Cohen, MD; Robert M Brody, MD
Institution(s): University of Pennsylvania Department of Otorhinolaryngology- Head and Neck Surgery


 The aims of this report are to (1) synthesize the existing literature on epidemiologic associations between HPV+ gyncologic and oropharyngeal cancer and (2) describe the prevalence of cervical, vulvar, and vaginal cancer or dysplasia in patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with primary transoral robotic surgery (TORS).

Study Design: Literature review and case series.

Methods: Chart review was conducted on female patients with HPV+ OPSCC receiving primary TORS at an academic medical center from March 2007 to March 2021, with a minimum of one year follow-up. Data collected included demographics, past medical and surgical history, treatment, survival, and recurrence, if applicable. Data was analyzed with descriptive statistics and Kaplan-Meier analysis.

Results: Out of 92 women patients, 8.7% (8/92) had a history of an HPV-positive gynecologic precancerous or cancerous lesion, including 2 with cervical cancer, 3 with cervical dysplasia, 2 with vulvar cancer, and 1 with vaginal dysplasia. In addition, 17 women had a history of hysterectomy without documented evidence of gynecologic (pre)cancerous lesions and were excluded. The median age for patients with a history of an HPV-positive gynecologic lesion was 54 years (IQR: 53-70). All 8 women were surgically treated for their gynecologic disease and were disease-free at time of primary surgery for OPSCC. Pathological stage for OPSCC were stage III (5), IVa (2), and IVb (1).Treatment failure was reported in 2 out of 8 women, with one case of locoregional recurrence and one of distant recurrence. No difference in overall survival was noted between women with or without a history of an HPV-positive gynecologic (pre)cancerous lesion (p = 0.25). 

Conclusions: A history of gynecologic cancer or dysplasia can be frequently found in women with HPV+ OPSCC. Further study of this subgroup of patients with oropharyngeal and cervical co-infection may elucidate mechanisms of HPV susceptibility.