PP028: The prognosis of premalignant mouth lesions associated with HPV infection

Purpose A part of the population develops oral cancer without exposure to traditional risk factors (tobacco, alcohol) suggesting that additional causes, such as viral agents, may participate in oral carcinogenesis. Thinking about the possibility of the evolution of premalignant lesions to cancer, it is essential to determine the role of viruses in the evolutionary process of the disease. Our objective in this study was to evaluate through a systematic review of the literature, the prognosis of oral premalignant lesions related to HPV. Material and methods Electronic searching of literature was undertaken. The NIH Pubmed search engine was employed to search for citations published through October 2012 using the MeSH terms: Papillomaviridae, Precancerous Conditions, Mouth Diseases, PCR, AND Risk. Data were extracted and methodological quality was assessed independently by two reviewers. The inclusion criteria were: type-specific HPV results from premalignant oral lesion, clearly described HPV testing methods, lesions at any oral site. The exclusion criteria were: carcinomas or normal oral mucosa, studies in patients with immunodeficiency, mixed population of HPV infection in head and neck region, mixed population of primary and previously treated SCC. Results We retrieved 32 articles of which were discarded 13 according to criteria previously described. The remaining 19 articles represent the study of 1.118 patients with premalignant oral lesions. The prevalence of HPV in the lesions ranged from 0% to 78.6% in different studies. Ten of the nineteen studies concluded that HPV is a prognostic indicator associated with the development of carcinoma of the mouth. Conclusions There is a lack of robust evidence in the literature on this subject. The great heterogeneity of the studies does not allow definitive conclusions and highlights the need for extensive research on this topic.