Prognostic factors for human papillomavirus–positive and negative oropharyngeal carcinomas

Yin, Linda X.; D’Souza, Gypsyamber; Westra, William H.; Wang, Steven J.; Zante, Annemieke van; Zhang, Yuehan; Rettig, Eleni M.; Ryan, William R.; Ha, Patrick K.; Wentz, Alicia; Koch, Wayne M.; Eisele, David W.; Fakhry, Carole

doi:10.1002/lary.27130

Cited by 22 publications

(31 citation statements)

References 53 publications

(128 reference statements)

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“…12,26 In contrast, our analysis found no sex-based differences in survival among patients with HPV-OPC, and women with HPV-negative OPC showed a survival disadvantage compared with men. Previously, analyses of a bi-institutional cohort oversampled for women and nonwhite patients found that women had a survival advantage over men among patients with HPV-OPC but not HPV-negative OPC.…”

Section: Discussioncontrasting

confidence: 87%

“…Previously, analyses of a bi-institutional cohort oversampled for women and nonwhite patients found that women had a survival advantage over men among patients with HPV-OPC but not HPV-negative OPC. 12,26 In contrast, our analysis found no sex-based differences in survival among patients with HPV-OPC, and women with HPV-negative OPC showed a survival disadvantage compared with men. It is possible that the previous smaller study suffered from sampling bias due to study design.…”

Section: Discussioncontrasting

confidence: 87%

“…[10][11][12]26,30 Investigations into the prognostic role of race/ethnicity on OPC have been dominated by comparisons between black and white patients, and limited studies have stratified by HPV tumor status. [10][11][12]26,30 Investigations into the prognostic role of race/ethnicity on OPC have been dominated by comparisons between black and white patients, and limited studies have stratified by HPV tumor status.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated racial differences in survival among patients with OPC. [10][11][12]26,30 Investigations into the prognostic role of race/ethnicity on OPC have been dominated by comparisons between black and white patients, and limited studies have stratified by HPV tumor status. 11,12,[30][31][32][33][34] Studies to date were underpowered to detect the interactions between HPV tumor status, sex, and race on prognosis.…”

Section: Discussionmentioning

confidence: 99%

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The prevalence of human papillomavirus in oropharyngeal cancer is increasing regardless of sex or race, and the influence of sex and race on survival is modified by human papillomavirus tumor status

Faraji

Rettig

Tsai

et al. 2018

Cancer

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BACKGROUND:The purpose of this study was to evaluate the influence of sex and race/ethnicity upon prevalence trends of human papillomavirus (HPV) in oropharyngeal cancer (OPC) and survival after OPC. METHOD: This was a cohort study of patients included in the United States National Cancer Database who had been diagnosed with OPC between 2010 and 2015. Outcomes were HPV status of tumor specimens and overall survival. Sex-and race-stratified trends in HPV prevalence were estimated using generalized linear modeling. The influence of sex, race, and HPV tumor status on overall survival was compared by Kaplan-Meier method and Cox Proportional Hazards models. RESULTS: This analysis included 20,886 HPV-positive and 10,364 HPV-negative OPC patients. The prevalence of HPV-positive tumors was higher among men (70.6%) than women (56.3%) and increased significantly over time at a rate of 3.5% and 3.2% per year among men and women, respectively. The prevalence of HPV-positive tumors was highest among whites (70.2%), followed by Hispanics (61.3%), Asians (55.8%), and blacks (46.3%). Blacks and Hispanics experienced significantly more rapid increases in prevalence of HPV-positive tumors over time compared with whites (6.5% vs 5.6% vs 3.2% per year, respectively). In HPV-positive OPC, neither sex nor race/ethnicity was associated with survival among patients with HPV-positive OPC. In contrast, for HPV-negative OPC, risk of death was significantly higher for women versus men (adjusted hazard ratio [aHR], 1.17; 95% confidence interval [CI], 1.08-1.26) and blacks versus whites (aHR, 1.21; 95% CI, 1.10-1.33). CONCLUSION: The prevalence of HPVpositive tumors is increasing for all sex and race/ethnicity groups in the United States. Sex and race are independently associated with survival for HPV-negative but not HPV-positive OPC. Cancer 2019;125:761-769.

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Section: Discussioncontrasting

confidence: 87%

Section: Discussioncontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The prevalence of human papillomavirus in oropharyngeal cancer is increasing regardless of sex or race, and the influence of sex and race on survival is modified by human papillomavirus tumor status

Faraji

Rettig

Tsai

et al. 2018

Cancer

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“…These results are in agreement with a previous study by Yin et al investigating the prognostic factors in HPV− vs HPV+ cohorts. 14 In their study, they found that females had superior outcomes to men (HR: 0.34, 95% CI = 0.12-0.96, P = .04) in HPV+ OPSCC. They were however unable to find a survival difference between genders in the HPV− cohort (P = .10).…”

Section: Discussionmentioning

confidence: 92%

Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study

et al. 2019

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Background: Oropharyngeal squamous cell carcinomas (OPSCC) can occur in either tonsillar related areas (TRA) or nontonsillar areas (nTRA). The prognostic differences between these sites are unclear. This study investigated this question using the National Cancer Database (NCDB), controlling for other confounders including human papillomavirus (HPV) status. Methods: This NCDB study was conducted by stratifying the HPV-positive oropharyngeal cancer cohort into two primary groups, TRA and nTRA. Kaplan Meier survival analysis was stratified according to HPV status, and further analysis was conducted using multivariable Cox regression.Results: A total of 23 297 patients were included in this study. In the multivariable cox regression analysis, OPSCC subsite was found to be an independent prognostic factor for survival (TRA vs nTRA HR: 0.76, 95% CI: 0.67-0.86, P < .0001). Conclusion: In this large cohort, OPSCC subsite was found to be an independent prognostic factor for survival.

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Systematic review and meta‐analysis of racial survival disparities among oropharyngeal cancer cases by HPV status

et al. 2020

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Background There is a well documented racial disparity in overall survival for oropharyngeal squamous cell carcinoma (OPSCC); however, it is unknown to what extent this disparity varies by HPV‐status. Methods A literature search was conducted through December 2019 using Ovid Medline, Cochrane Library, Embase, Scopus, and http://Clinicaltrials.gov. PRISMA guidelines were followed. A meta‐analysis was conducted using random effects models to obtain pooled hazard ratios (HRs). Results Of 649 studies initially identified, 20 studies met criteria for the narrative review. There were four studies evaluating survival by race in HPV‐positive OPSCC and five studies in HPV‐negative OPSCC suitable for pooling. The pooled HR associated with black race was 1.10 (95% CI 0.96‐1.23) among patients with HPV‐positive (n = 23 608) and 1.50 (95% CI 1.12‐1.88) among patients with HPV‐negative (n = 12 112). There was notable heterogeneity (I2 = 83%) and publication bias among the HPV‐negative OPSCC studies. Conclusions The racial disparity in OPSCC survival persists for HPV‐negative disease and is nonsignificant for HPV‐positive disease. Unmeasured differences in socioeconomic status and access to care may contribute to this disparity.

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Prognostic factors for human papillomavirus–positive and negative oropharyngeal carcinomas

Abstract: 4 Laryngoscope, E287-E295, 2018.

Cited by 22 publications

References 53 publications

The prevalence of human papillomavirus in oropharyngeal cancer is increasing regardless of sex or race, and the influence of sex and race on survival is modified by human papillomavirus tumor status

The prevalence of human papillomavirus in oropharyngeal cancer is increasing regardless of sex or race, and the influence of sex and race on survival is modified by human papillomavirus tumor status

Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study

Systematic review and meta‐analysis of racial survival disparities among oropharyngeal cancer cases by HPV status

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