Stein Eva, Lenze Nicholas R, Yarbrough Wendell G, Hayes D Neil, Mazul Angela, Sheth Siddharth
Department of Medicine, University of Colorado, Denver, Colorado, USA.
Department of Otolaryngology/Head & Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
Head Neck. 2020 Oct;42(10):2985-3001. doi: 10.1002/hed.26328. Epub 2020 Jul 7.
There is a well documented racial disparity in overall survival for oropharyngeal squamous cell carcinoma (OPSCC); however, it is unknown to what extent this disparity varies by HPV-status.
A literature search was conducted through December 2019 using Ovid Medline, Cochrane Library, Embase, Scopus, and Clinicaltrials.gov. PRISMA guidelines were followed. A meta-analysis was conducted using random effects models to obtain pooled hazard ratios (HRs).
Of 649 studies initially identified, 20 studies met criteria for the narrative review. There were four studies evaluating survival by race in HPV-positive OPSCC and five studies in HPV-negative OPSCC suitable for pooling. The pooled HR associated with black race was 1.10 (95% CI 0.96-1.23) among patients with HPV-positive (n = 23 608) and 1.50 (95% CI 1.12-1.88) among patients with HPV-negative (n = 12 112). There was notable heterogeneity (I = 83%) and publication bias among the HPV-negative OPSCC studies.
The racial disparity in OPSCC survival persists for HPV-negative disease and is nonsignificant for HPV-positive disease. Unmeasured differences in socioeconomic status and access to care may contribute to this disparity.
口咽鳞状细胞癌（OPSCC）的总生存率存在明显的种族差异，这一点已有充分记录；然而，这种差异在多大程度上因HPV状态而异尚不清楚。
通过使用Ovid Medline、Cochrane图书馆、Embase、Scopus和Clinicaltrials.gov进行文献检索，检索截至2019年12月的文献。遵循PRISMA指南。使用随机效应模型进行荟萃分析以获得合并风险比（HRs）。
在最初确定的649项研究中，有20项研究符合叙述性综述的标准。有4项研究评估了HPV阳性OPSCC患者的种族生存率，5项研究评估了HPV阴性OPSCC患者的种族生存率，这些研究适合进行汇总分析。在HPV阳性患者（n = 23608）中，与黑人种族相关的合并HR为1.10（95%CI 0.96 - 1.23），在HPV阴性患者（n = 12112）中为1.50（95%CI 1.12 - 1.88）。HPV阴性OPSCC研究中存在显著的异质性（I = 83%）和发表偏倚。
OPSCC生存率的种族差异在HPV阴性疾病中持续存在，而在HPV阳性疾病中不显著。社会经济地位和医疗服务可及性方面未测量的差异可能导致了这种差异。
