Prognostic factors for human papillomavirus-positive and negative oropharyngeal carcinomas

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

Research output: Contribution to journalArticle

Abstract

Objectives/Hypothesis: Human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) are distinct disease entities. Prognostic factors specific to each entity have not been adequately explored. Goals for this study were: 1) to determine whether HPV-positive and HPV-negative OPSCCs have distinct prognostic factors, and 2) to explore the prognostic significance of sex and race in OPSCC after HPV stratification Study Design: Retrospective case series. Methods: A retrospective review of 239 incident OPSCC patients from 1995 to 2012, treated at Johns Hopkins and University of California-San Francisco was conducted. Women and nonwhite races were oversampled. All analyses were stratified by tumor HPV in situ hybridization status. The effects of sex and race on survival were considered in Kaplan-Meier and unadjusted and adjusted Cox regression models. Results: One hundred thirty-four (56.1%) OPSCC patients were HPV positive. On univariate analysis, women had better overall survival than men among HPV-positive (hazard ratio [HR]: 0.47, 95% confidence interval [CI]: 0.20-1.07; P=.06) but not HPV-negative (HR: 0.73, 95% CI: 0.43-1.24; P=.24) OPSCCs. On multivariate analysis, women with HPV-positive OPSCCs remained at lower risk of death (adjusted hazard ratio [aHR]: 0.34, 95% CI: 0.12-0.96; P=.04). Survival did not vary significantly by race among HPV-positive patients. Among HPV-negative patients, Hispanic patients had significantly better survival in unadjusted (HR: 0.27, 95% CI: 0.08-0.91; P=.04) but not adjusted (aHR: 0.93, 95% CI: 0.11-7.36; P=.94) analysis. Conclusions: Women with HPV-positive OPSCC may have improved overall survival compared to men. Sex does not play a prognostic role in HPV-negative OPSCC. There are no differences in prognosis by race among HPV-positive or HPV-negative patients.

Original languageEnglish (US)
JournalLaryngoscope
DOIs
StateAccepted/In press - Jan 1 2018

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Carcinoma
Squamous Cell Carcinoma
Confidence Intervals
Survival
San Francisco
Hispanic Americans
Proportional Hazards Models
In Situ Hybridization
Multivariate Analysis
Retrospective Studies

Keywords

  • Head and neck oncology
  • Human papillomavirus
  • Oropharyngeal
  • Prognostic factors
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

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Prognostic factors for human papillomavirus-positive and negative oropharyngeal carcinomas. / Yin, Linda X.; D'Souza, Gypsyamber; Westra, William H.; Wang, Steven J.; van Zante, Annemieke; Zhang, Yuehan; Rettig, Eleni M.; Ryan, William R.; Ha, Patrick K.; Wentz, Alicia; Koch, Wayne Martin; Eisele, David W; Fakhry, Carole.

In: Laryngoscope, 01.01.2018.

Research output: Contribution to journalArticle

Yin, Linda X. ; D'Souza, Gypsyamber ; Westra, William H. ; Wang, Steven J. ; van Zante, Annemieke ; Zhang, Yuehan ; Rettig, Eleni M. ; Ryan, William R. ; Ha, Patrick K. ; Wentz, Alicia ; Koch, Wayne Martin ; Eisele, David W ; Fakhry, Carole. / Prognostic factors for human papillomavirus-positive and negative oropharyngeal carcinomas. In: Laryngoscope. 2018.
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title = "Prognostic factors for human papillomavirus-positive and negative oropharyngeal carcinomas",
abstract = "Objectives/Hypothesis: Human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) are distinct disease entities. Prognostic factors specific to each entity have not been adequately explored. Goals for this study were: 1) to determine whether HPV-positive and HPV-negative OPSCCs have distinct prognostic factors, and 2) to explore the prognostic significance of sex and race in OPSCC after HPV stratification Study Design: Retrospective case series. Methods: A retrospective review of 239 incident OPSCC patients from 1995 to 2012, treated at Johns Hopkins and University of California-San Francisco was conducted. Women and nonwhite races were oversampled. All analyses were stratified by tumor HPV in situ hybridization status. The effects of sex and race on survival were considered in Kaplan-Meier and unadjusted and adjusted Cox regression models. Results: One hundred thirty-four (56.1{\%}) OPSCC patients were HPV positive. On univariate analysis, women had better overall survival than men among HPV-positive (hazard ratio [HR]: 0.47, 95{\%} confidence interval [CI]: 0.20-1.07; P=.06) but not HPV-negative (HR: 0.73, 95{\%} CI: 0.43-1.24; P=.24) OPSCCs. On multivariate analysis, women with HPV-positive OPSCCs remained at lower risk of death (adjusted hazard ratio [aHR]: 0.34, 95{\%} CI: 0.12-0.96; P=.04). Survival did not vary significantly by race among HPV-positive patients. Among HPV-negative patients, Hispanic patients had significantly better survival in unadjusted (HR: 0.27, 95{\%} CI: 0.08-0.91; P=.04) but not adjusted (aHR: 0.93, 95{\%} CI: 0.11-7.36; P=.94) analysis. Conclusions: Women with HPV-positive OPSCC may have improved overall survival compared to men. Sex does not play a prognostic role in HPV-negative OPSCC. There are no differences in prognosis by race among HPV-positive or HPV-negative patients.",
keywords = "Head and neck oncology, Human papillomavirus, Oropharyngeal, Prognostic factors, Squamous cell carcinoma",
author = "Yin, {Linda X.} and Gypsyamber D'Souza and Westra, {William H.} and Wang, {Steven J.} and {van Zante}, Annemieke and Yuehan Zhang and Rettig, {Eleni M.} and Ryan, {William R.} and Ha, {Patrick K.} and Alicia Wentz and Koch, {Wayne Martin} and Eisele, {David W} and Carole Fakhry",
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journal = "Laryngoscope",
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T1 - Prognostic factors for human papillomavirus-positive and negative oropharyngeal carcinomas

AU - Yin, Linda X.

AU - D'Souza, Gypsyamber

AU - Westra, William H.

AU - Wang, Steven J.

AU - van Zante, Annemieke

AU - Zhang, Yuehan

AU - Rettig, Eleni M.

AU - Ryan, William R.

AU - Ha, Patrick K.

AU - Wentz, Alicia

AU - Koch, Wayne Martin

AU - Eisele, David W

AU - Fakhry, Carole

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives/Hypothesis: Human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) are distinct disease entities. Prognostic factors specific to each entity have not been adequately explored. Goals for this study were: 1) to determine whether HPV-positive and HPV-negative OPSCCs have distinct prognostic factors, and 2) to explore the prognostic significance of sex and race in OPSCC after HPV stratification Study Design: Retrospective case series. Methods: A retrospective review of 239 incident OPSCC patients from 1995 to 2012, treated at Johns Hopkins and University of California-San Francisco was conducted. Women and nonwhite races were oversampled. All analyses were stratified by tumor HPV in situ hybridization status. The effects of sex and race on survival were considered in Kaplan-Meier and unadjusted and adjusted Cox regression models. Results: One hundred thirty-four (56.1%) OPSCC patients were HPV positive. On univariate analysis, women had better overall survival than men among HPV-positive (hazard ratio [HR]: 0.47, 95% confidence interval [CI]: 0.20-1.07; P=.06) but not HPV-negative (HR: 0.73, 95% CI: 0.43-1.24; P=.24) OPSCCs. On multivariate analysis, women with HPV-positive OPSCCs remained at lower risk of death (adjusted hazard ratio [aHR]: 0.34, 95% CI: 0.12-0.96; P=.04). Survival did not vary significantly by race among HPV-positive patients. Among HPV-negative patients, Hispanic patients had significantly better survival in unadjusted (HR: 0.27, 95% CI: 0.08-0.91; P=.04) but not adjusted (aHR: 0.93, 95% CI: 0.11-7.36; P=.94) analysis. Conclusions: Women with HPV-positive OPSCC may have improved overall survival compared to men. Sex does not play a prognostic role in HPV-negative OPSCC. There are no differences in prognosis by race among HPV-positive or HPV-negative patients.

AB - Objectives/Hypothesis: Human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) are distinct disease entities. Prognostic factors specific to each entity have not been adequately explored. Goals for this study were: 1) to determine whether HPV-positive and HPV-negative OPSCCs have distinct prognostic factors, and 2) to explore the prognostic significance of sex and race in OPSCC after HPV stratification Study Design: Retrospective case series. Methods: A retrospective review of 239 incident OPSCC patients from 1995 to 2012, treated at Johns Hopkins and University of California-San Francisco was conducted. Women and nonwhite races were oversampled. All analyses were stratified by tumor HPV in situ hybridization status. The effects of sex and race on survival were considered in Kaplan-Meier and unadjusted and adjusted Cox regression models. Results: One hundred thirty-four (56.1%) OPSCC patients were HPV positive. On univariate analysis, women had better overall survival than men among HPV-positive (hazard ratio [HR]: 0.47, 95% confidence interval [CI]: 0.20-1.07; P=.06) but not HPV-negative (HR: 0.73, 95% CI: 0.43-1.24; P=.24) OPSCCs. On multivariate analysis, women with HPV-positive OPSCCs remained at lower risk of death (adjusted hazard ratio [aHR]: 0.34, 95% CI: 0.12-0.96; P=.04). Survival did not vary significantly by race among HPV-positive patients. Among HPV-negative patients, Hispanic patients had significantly better survival in unadjusted (HR: 0.27, 95% CI: 0.08-0.91; P=.04) but not adjusted (aHR: 0.93, 95% CI: 0.11-7.36; P=.94) analysis. Conclusions: Women with HPV-positive OPSCC may have improved overall survival compared to men. Sex does not play a prognostic role in HPV-negative OPSCC. There are no differences in prognosis by race among HPV-positive or HPV-negative patients.

KW - Head and neck oncology

KW - Human papillomavirus

KW - Oropharyngeal

KW - Prognostic factors

KW - Squamous cell carcinoma

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