LAUSR

Because of the lack of data and studies on metastatic non-oropharyngeal head and neck cancer (non-OP HNC), the role of human papillomavirus (HPV) status in non-OP HNC with distant metastasis is still unclear. Therefore, we conducted a study to explore the differences in metastatic patterns, survival and treatment responses in metastatic non-OP HNC based on HPV status. A total of 333 metastatic non-OP HNC patients were diagnosed from 2010 to 2016 in the Surveillance, Epidemiology and End Results (SEER) database. The chi‐square test and Fisher's exact test were used to make comparisons for categorical variables. The Kaplan–Meier method and Cox regression analyses were used to analyse survival. HPV status was a significant prognostic variable for patients with non-OP HNC with distant metastasis. HPV− patients were more likely to have distant metastasis and worse prognosis and treatment response than HPV+ patients. Only chemotherapy was an independent prognostic factor for HPV+ patients with distant metastasis, while chemotherapy and radiotherapy were both independent prognostic factors for HPV− patients with distant metastasis. The treatment response was associated with the metastatic pattern in both HPV+ and HPV− populations and showed significant differences based on HPV status and metastatic pattern. For non-OP HNC with distant metastasis, HPV+ and HPV− patients formed two different cohorts in terms of metastatic pattern, survival and treatment. Therefore, it is helpful to classify metastatic non-OP HNC into different groups to choose appropriate treatment strategies according to HPV status and metastatic pattern.