Evaluating human papillomavirus testing, prevalence, and association with prognosis in head and neck squamous cell carcinoma by subsite: A national cancer database study.
Am J Otolaryngol
; 45(3): 104243, 2024.
Article
in En
| MEDLINE
| ID: mdl-38442460
ABSTRACT
PURPOSE:
To compare human papillomavirus (HPV) testing, prevalence, and association with prognosis between head and neck squamous cell carcinoma (HNSCC) subsites. MATERIALS ANDMETHODS:
This study utilized the National Cancer Database (NCDB) to identify patients diagnosed with HNSCC between 2010 and 2017. Rates of HPV testing, HPV-positivity, and changes in these rates over time were measured by subsite. The impact of HPV-positivity on overall survival across six head and neck subsites was assessed using multivariable-adjusted Cox proportional hazards analysis.RESULTS:
A total of 121,550 patients were included. Of this cohort, 87,575 (72.1%) were tested for HPV, with the oropharynx (55,049/64,158; 85.8%) displaying the highest rates of testing and the sinonasal tract (1519/2853; 53.2%) displaying the lowest testing rates. Of the 86,136 with a definitive result, 46,878 (54.4%) were HPV-positive, with the oropharynx (40,313/54,205; 74.4%) displaying the highest rates of HPV-positivity and the oral cavity (1818/11,505; 15.8%) displaying the lowest. HPV-positive malignancy was associated with significantly improved adjusted overall survival in the oropharynx (HR = 0.42 [95% CI 0.43-0.47]), oral cavity (HR = 0.86 [95% CI 0.79-0.95]), sinonasal tract (HR = 0.63 [95% CI 0.48-0.83]), larynx (HR = 0.78 [95% CI 0.71-0.87]), and hypopharynx (HR = 0.56 [95% CI 0.48-0.66]), but not the nasopharynx (HR = 0.93 [95% CI 0.77-1.14]).CONCLUSION:
HPV testing rates were significantly lower in non-oropharyngeal subsites. This is relevant as HPV-associated disease displayed significantly improved overall survival in both the oropharynx and four of five non-oropharyngeal subsites. While validation with prospective studies is necessary, these findings may warrant HPV testing in all HNSCC subsites.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Databases, Factual
/
Papillomavirus Infections
/
Squamous Cell Carcinoma of Head and Neck
/
Head and Neck Neoplasms
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Otolaryngol
Year:
2024
Document type:
Article