Wookey Vanessa B, Appiah Adams Kusi, Kallam Avyakta, Ernani Vinicius, Smith Lynette M, Ganti Apar Kishor
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, U.S.A.
Department of Biostatistics, University of Nebraska Medical Center, College of Public Health, Omaha, NE, U.S.A.
Anticancer Res. 2019 Apr;39(4):1907-1914. doi: 10.21873/anticanres.13299.
BACKGROUND/AIM: HPV-mediated oropharyngeal squamous cell carcinoma is associated with an increased survival. The prognostic value of HPV status for other primary sites is unclear. We aimed to assess the effect of HPV status on overall survival in patients with non-oropharyngeal head and neck squamous cell carcinoma (non-OPSCC) using the National Cancer Database (NCDB).
Adults with non-OPSCC [gum, lip, floor of mouth, tongue (excluding base), hypopharynx, nasopharynx, other pharynx] and known HPV status were included in our study. Associations between HPV status, primary site, patient characteristics and overall survival (OS) were assessed.
HPV positivity was associated with a better OS compared to HPV-negative patients (HR=0.83, 95%CI=0.74-0.93, p<0.001). Female gender, gum, lip, nasopharynx primaries, and private insurance predicted for improved OS.
HPV positivity and female gender are good prognostic factors in non-OPSCC. Routine HPV testing should be considered for HPV positive non-OPSCC, as well as studies evaluating de-escalation of treatment if this association is confirmed.
背景/目的：人乳头瘤病毒（HPV）介导的口咽鳞状细胞癌患者生存率有所提高。HPV状态对其他原发部位的预后价值尚不清楚。我们旨在利用国家癌症数据库（NCDB）评估HPV状态对非口咽头颈鳞状细胞癌（non-OPSCC）患者总生存期的影响。
本研究纳入患有non-OPSCC[牙龈、唇、口底、舌（不包括舌根）、下咽、鼻咽、其他咽部]且已知HPV状态的成年人。评估HPV状态、原发部位、患者特征与总生存期（OS）之间的关联。
与HPV阴性患者相比，HPV阳性患者的总生存期更佳（风险比[HR]=0.83，95%置信区间[CI]=0.74 - 0.93，p<0.001）。女性、牙龈、唇、鼻咽原发部位以及私人保险预示总生存期改善。
HPV阳性和女性是non-OPSCC的良好预后因素。对于HPV阳性的non-OPSCC患者应考虑进行常规HPV检测，以及在该关联得到证实时评估降阶梯治疗的研究。
