Abstract
Background
Oropharyngeal squamous cell carcinoma (OPSCC) of human papillomavirus (HPV)-positive status is increasing relative to HPV-negative disease. Nutritional features of OPSCC patients according to HPV status is unclear.
Subjects/methods
Canadian and Spanish patients with OPSCC were assessed for body mass index (BMI), weight loss grade (WLG), and computed tomography-defined skeletal muscle index (SMI). Chi-square, t-test, Mann-Whitney-U, Kruskal-Wallis tests were conducted to compare HPV positive and negative groups. Overall survival (OS) was assessed by univariable Kaplan–Meier and Cox proportional hazard methods.
Results
No differences in BMI, WLG, SMI, and adipose tissue index between the 308 (Canada) and 134 (Spain) patients according to HPV status; hence cohorts were pooled (n = 442). HPV-positive patients (n = 317) were overweight/obese (72.8%), had WLG of 0/1 (59.6%) and high SMI (83.4%) while HPV-negative patients were normal/underweight (61.5%), had high WLG 3/4 (50.8%), and moderate/severe SMI depletion (46.9%) (p < 0.003). These overall differences notwithstanding, there was crossover i.e. 35% of HPV-positive patients had high WLG and/or moderate/severe muscle depletion and 29% of HPV-negative patients had minimal weight loss and high SMI. HPV-negative patients had a higher risk of mortality (HR 3.78, 95% CI 2.70–5.29, P < 0.001) and this difference was retained after multivariable adjustment for WLG, SMI, age, disease stage, and planned treatment (HR 3.30, 95% CI 2.17–5.02, P < 0.001).
Conclusion
Nutrition features of patients with OPSCC did not differ between Canada and Spain. Distinctive nutrition features exist in patients according to HPV status. The high heterogeneity of individual nutritional profiles invites an individualized approach to nutrition care.
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Data availability
The data that support the findings of this study are available on request from both corresponding authors, LA and VB. The data are not publicly available due to restrictions related to the participant’s privacy.
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Acknowledgements
We would like to express our sincere gratitude to all the patients for their participation in this project. We wish to thank all the members of the research team who contributed to the successful completion of this study. Their technical assistance, critical advice, and dedication have been instrumental in the accomplishment of our research objectives.
Funding
Instituto de Salud Carlos III has funded MC through the grant FI20/00103 (Co-founded by European Social Foundation ESF investing in your future). The rest of the authors did not receive financial support from any organization for the present work.
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The authors confirm contribution to the paper as follows: study conception and design: VB, RM, LA, MC, CK; data collection: MC, CK, LA, VB; analysis and interpretation of results: MC, CK, VB; draft manuscript preparation: MC, CK, VB, LA. VB, RM, LA, MC, CK, FM, JB, ST, BQ, XW, MAP, MG, MT, LA, MO, MM, NJ, RS, BD, NC, JW reviewed the results and approved the final version of the manuscript.
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The authors declare no competing interests.
Ethics approval and consent to participate
The present study was developed according to the Declaration of Helsinki and have the ethical approval from the institutional research ethics boards from both countries. For Spain was the Hospital Universitari de Bellvitge Ethics Committee for Clinical Research with the protocol number PR138/19. An informed consent was obtained from all patients included in the Spanish cohort. And for Canada, the Health Research Ethics Board of Alberta (HREBA)—Cancer with the protocol number CC_17-0433. The HREBA approved waiver of an informed consent for the Canadian cohort.
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Choulli, M., Kubrak, C., Morey, F. et al. Nutritional characterization of patients with oropharyngeal cancers: impact of human papillomavirus status. Eur J Clin Nutr 79, 467–474 (2025). https://doi.org/10.1038/s41430-024-01556-z
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DOI: https://doi.org/10.1038/s41430-024-01556-z
