Survival Rates for Patients With Barrett High-grade Dysplasia and Esophageal Adenocarcinoma With or Without Human Papillomavirus Infection

Rajendra, Shanmugarajah; Xuan, Wei; Merrett, Neil D.; Sharma, Preeti; Pavey, Darren; Yang, Tao; Santos, Leonardo D.; Sharaiha, Omar; Pande, Girish; Cosman, Peter H.; Wu, Xiaojuan; Wang, Bin

doi:10.1001/jamanetworkopen.2018.1054

Cited by 20 publications

(21 citation statements)

References 42 publications

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“…The findings presented in the current study contribute to a growing body of literature describing HPV‐associated cancers in sites that have not classically been linked with HPV infection; reports have demonstrated HPV status to be highly prognostic in patients with anal and esophageal cancers . Treatment de‐escalation has been the subject of active research for patients with SCC of the OPX.…”

Section: Discussionmentioning

confidence: 60%

“…[34][35][36] The findings presented in the current study contribute to a growing body of literature describing HPVassociated cancers in sites that have not classically been linked with HPV infection; reports have demonstrated HPV status to be highly prognostic in patients with anal and esophageal cancers. 37,38 Treatment de-escalation has been the subject of active research for patients with SCC of the OPX. Several ongoing and recently completed randomized studies in the cooperative group setting have used induction chemotherapy, transoral robotic surgery, or definitive chemoradiotherapy strategies.…”

Section: Kaplan-meier Plotmentioning

confidence: 99%

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Survival outcomes by high‐risk human papillomavirus status in nonoropharyngeal head and neck squamous cell carcinomas: A propensity‐scored analysis of the National Cancer Data Base

Tian

Switchenko

Jhaveri

et al. 2019

Cancer

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Background The prognostic relevance of human papillomavirus (HPV) status in patients with nonoropharyngeal (OPX) squamous cell cancer (SCC) of the head and neck is controversial. In the current study, the authors evaluated the impact of high‐risk HPV status on overall survival (OS) in patients with non‐OPX SCC using a large database approach. Methods The National Cancer Data Base was queried to identify patients diagnosed from 2004 through 2014 with SCC of the OPX, hypopharynx (HPX), larynx, and oral cavity (OC) with known HPV status. Survival was estimated using Kaplan‐Meier methods; distributions were compared using log‐rank tests. Propensity score–matching and inverse probability of treatment weighing (IPTW) methods were used; cohorts were matched based on age, sex, Charlson‐Deyo score, clinical American Joint Committee on Cancer (AJCC) group stage, treatments received, and anatomic subsite. Propensity analyses were stratified by group stage of disease. Results A total of 24,740 patients diagnosed from 2010 through 2013 were analyzed: 1085 patients with HPX, 4804 with laryngeal, 4,018 with OC, and 14,833 with OPX SCC. The percentages of HPV‐positive cases by disease site were 17.7% for HPX, 11% for larynx, 10.6% for OC, and 62.9% for OPX. HPV status was found to be prognostic in multiple unadjusted and propensity‐adjusted non‐OPX populations. HPV positivity was associated with superior OS in patients with HPX SCC with a hazard ratio (HR) of 0.61 (P < .001 by IPTW), in patients with AJCC stage III to IVB laryngeal SCC (HR, 0.79; P = .019 by IPTW), and in patients with AJCC stage III to IVB OC SCC (HR, 0.78; P = .03 by IPTW). Conclusions Positive high‐risk HPV status appears to be associated with longer OS in multiple populations of patients with non‐OPX head and neck disease (HPX, locally advanced larynx, and OC). If prospectively validated, these findings have implications for risk stratification.

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Section: Discussionmentioning

confidence: 60%

Section: Kaplan-meier Plotmentioning

confidence: 99%

Survival outcomes by high‐risk human papillomavirus status in nonoropharyngeal head and neck squamous cell carcinomas: A propensity‐scored analysis of the National Cancer Data Base

Tian

Switchenko

Jhaveri

et al. 2019

Cancer

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“…These data are depicted in eTable 1 in the Supplement and in a previous publication. 11 There were no significant differences in…”

Section: Patient Characteristicsmentioning

confidence: 86%

Association of Biomarkers for Human Papillomavirus With Survival Among Adults With Barrett High-grade Dysplasia and Esophageal Adenocarcinoma

et al. 2020

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IMPORTANCE The presence of high-risk human papillomavirus (HPV) has been associated with a favorable outcome in Barrett high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). Nevertheless, the prognostic significance of other HPV-related biomarkers (ie, retinoblastoma protein [pRb], cyclin D1 [CD1], minichromosome maintenance protein [MCM2] and Ki-67) is unknown. OBJECTIVE To examine the association between HPV-related biomarkers and survival in adult patients with Barrett HGD and EAC. DESIGN, SETTING, AND PARTICIPANTS This retrospective case-control study examined the hypothesis that the HPV-related cell cycle markers (pRb, CD1, and Ki-67) and the viral surrogate marker (MCM2) may be associated with a favorable prognosis in Barrett HGD and EAC. Pretreatment biopsies were used for HPV DNA determination via polymerase chain reaction and immunohistochemistry for the HPV-related biomarkers. Recruitment of patients occurred in secondary and tertiary referral centers, with 151 patients assessed for eligibility. The study period was

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“…62 HPV-positive Barrett's high-grade dysplasia and EAC seem to be distinct biological entities with a favorable prognosis compared with virus-negative esophageal tumors. 63,64 In a study involving 142 patients with Barrett's high-grade dysplasia and EAC (37 HPV-positive and 105 HPV-negative), there was a superior disease-free survival (DFS) in the virus-positive group (40.3 versus 24.1 months, difference = 16.2 months, 95% CI: 5.7-26.8, P = 0.003) and an enhanced OS (43.7 versus 29.8 months, difference = 13.9 months, 95% CI: 3.6-24.3, P = 0.009).…”

Section: Is Hpv Prognostic For Esophageal Cancer?mentioning

confidence: 99%

Human papillomavirus infection in esophageal squamous cell carcinoma and esophageal adenocarcinoma: a concise review

Rajendra

Pavey

McKay

et al. 2020

Annals of the New York Academy of Sciences

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The causal link between high-risk human papillomavirus (hr-HPV) infection and cervical, anogenital, and some oropharyngeal malignancies has been established by both molecular and epidemiological data. The association between HPV and esophageal squamous cell carcinoma (ESCC) remains controversial, as is the true prevalence of HPV infection in ESCC. The wide range in reported rates reflects variability in the primary literature, with some larger scale case-control studies suggesting the infection rates range from 0% to 78%. Interactions between HPV and the Barrett's metaplasia-dysplasia-carcinoma sequence have been explored, and these studies have shown some conflicting data. Overall, systematic reviews have reported the prevalence of HPV-positive DNA in esophageal adenocarcinoma patients of between 13% and 35%. Postulated reasons for discrepancies in HPV prevalence rates in esophageal cancer include variations in testing methodology and assay sensitivities; technical issues, including the lack of a gold-standard primer; types of specimens utilized (fresh-frozen versus formalin-fixed tissue); geographical variation; cross-contamination; and small sample sizes. Thus, efforts must be undertaken to (1) standardize HPV testing, ideally in a central laboratory and utilizing tests that detect viral transcriptional activity; (2) avoid cross-contamination; and (3) recruit large numbers of patients to accurately ascertain HPV rates in esophageal malignancy.

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Survival Rates for Patients With Barrett High-grade Dysplasia and Esophageal Adenocarcinoma With or Without Human Papillomavirus Infection

Cited by 20 publications

References 42 publications

Survival outcomes by high‐risk human papillomavirus status in nonoropharyngeal head and neck squamous cell carcinomas: A propensity‐scored analysis of the National Cancer Data Base

Survival outcomes by high‐risk human papillomavirus status in nonoropharyngeal head and neck squamous cell carcinomas: A propensity‐scored analysis of the National Cancer Data Base

Association of Biomarkers for Human Papillomavirus With Survival Among Adults With Barrett High-grade Dysplasia and Esophageal Adenocarcinoma

Human papillomavirus infection in esophageal squamous cell carcinoma and esophageal adenocarcinoma: a concise review

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