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Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

We examined overall survival in a large cohort of patients with human papillomavirus (HPV)-positive and HPV-negative non-oropharyngeal squamous cell carcinoma of the head and neck (non-OPSCC).

Methods

Patients diagnosed with non-OPSCC and known HPV status were identified in the National Cancer Database (NCDB). Multivariate logistic regression was applied to examine factors associated with HPV status. Multivariate analysis was utilized to determine factors correlated with overall survival. Propensity score-weighted Kaplan–Meier estimation was used to adjust for confounders in survival analyses. Multiple imputation method was used for sensitivity analysis.

Results

We identified 19,993 non-OPSCC patients with 5070 being positive for HPV in the NCDB. Median follow-up was 23.5 months. HPV-positive patients were more commonly male, white, with a lower comorbidity index score, presenting with T-stage <2, and N-stage ≥1. Unadjusted 3-year overall survival was 62% and 80% for HPV-negative and HPV-positive patients, respectively (p < 0.0001). On multivariate analysis, mortality was reduced for HPV-positive patients with early stage (HR = 0.68) and locally advanced disease (HR = 0.46). Adjusted 3-year overall survival was 65% for HPV-negative and 76% for HPV-positive patients (p < 0.0001). The survival advantage of HPV was maintained in all subsites and robust on sensitivity analysis.

Conclusions

Patients with HPV-positive non-OPSCC exhibit similar characteristics as HPV-positive OPSCC. Overall survival was significantly higher for patients with HPV-positive versus HPV-negative non-OPSCC. These data reveal that HPV-positive non-OPSCC represent a favorable cohort that warrants recognition in the design of future clinical trial investigation.

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Authors and Affiliations

  1. Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA

    Huaising C. Ko, Paul M. Harari, Andrew M. Baschnagel, Randall J. Kimple & Matthew E. Witek

  2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Ryan M. Sacotte

  3. Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Shuai Chen & Menggang Yu

  4. Division of Otolaryngology and Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Aaron M. Wieland

  5. Section of Hematology Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Justine Y. Bruce

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  1. Huaising C. Ko
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  2. Paul M. Harari
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  3. Ryan M. Sacotte
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  4. Shuai Chen
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  5. Aaron M. Wieland
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  6. Menggang Yu
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  7. Andrew M. Baschnagel
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  8. Justine Y. Bruce
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  9. Randall J. Kimple
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  10. Matthew E. Witek
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Corresponding author

Correspondence to Matthew E. Witek.

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Funding

This work was funded in part by NIH/NCI P30 CA014520-UW Comprehensive Cancer Center Grant and NIH P50 DE026787-UW Head and Neck SPORE Grant.

Conflict of interest

The authors have no conflicts of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Ko, H.C., Harari, P.M., Sacotte, R.M. et al. Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas. J Cancer Res Clin Oncol 143, 2341–2350 (2017). https://doi.org/10.1007/s00432-017-2481-8

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  • DOI: https://doi.org/10.1007/s00432-017-2481-8

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