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HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients

OBJECTIVES: Human papillomavirus (HPV) status is a favorable prognostic marker for patients with oropharyngeal squamous cell carcinoma (OPSCC) and non-metastatic head and neck non-OPSCC. We evaluated the impact of HPV status on overall survival (OS) for patients with Stage IVC non-OPSCC. MATERIALS A...

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Autores principales: Burr, Adam R, Harari, Paul M, Ko, Huaising C, Chen, Shuai, Yu, Menggang, Baschnagel, Andrew M, Kimple, Randall J, Witek, Matthew E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157736/
https://www.ncbi.nlm.nih.gov/pubmed/30271885
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author Burr, Adam R
Harari, Paul M
Ko, Huaising C
Chen, Shuai
Yu, Menggang
Baschnagel, Andrew M
Kimple, Randall J
Witek, Matthew E
author_facet Burr, Adam R
Harari, Paul M
Ko, Huaising C
Chen, Shuai
Yu, Menggang
Baschnagel, Andrew M
Kimple, Randall J
Witek, Matthew E
author_sort Burr, Adam R
collection PubMed
description OBJECTIVES: Human papillomavirus (HPV) status is a favorable prognostic marker for patients with oropharyngeal squamous cell carcinoma (OPSCC) and non-metastatic head and neck non-OPSCC. We evaluated the impact of HPV status on overall survival (OS) for patients with Stage IVC non-OPSCC. MATERIALS AND METHODS: Patients diagnosed with Stage IVC non-OPSCC and known HPV status between 2010–2013 were identified in the National Cancer Database. Univariate and multivariate analyses were performed to determine factors associated with OS. Propensity score-weighted Kaplan-Meier estimation was used to adjust for confounders in OS analyses. Multiple imputation method was used for sensitivity analysis. RESULTS: We identified 708 patients with Stage IVC non-OPSCC with 30% being HPV-positive. Unadjusted median survival was 10.3 months for HPV-negative patients and 21.4 months for HPV-positive patients (p<0.0001). Age ≥ 65 and tumor diameter were associated with worse OS (p<0.05) while treatment versus no treatment and HPV-positive status were associated with improved OS on multivariate analysis (p<0.001). Adjusted median survival for patients with HPV-negative and HPV-positive disease was 11.1 months and 23.8 months, respectively (p<0.001). On unadjusted subgroup analysis, patients with HPV-positive oral cavity disease exhibited improved outcomes (p<0.0001) while HPV-positive hypopharynx (p<0.06) and larynx (p<0.12) patients exhibited a trend for improved OS compared to HPV-negative patients. The survival advantage associated with HPV positivity was maintained on sensitivity analysis (p<0.01). CONCLUSION: These data demonstrate a clinically meaningful association between HPV status and OS in patients with non-OSPCC presenting with Stage IVC disease. In the absence of randomized data, these findings support active consideration of HPV status in clinical decision making, clinical trial design, and patient counseling regarding prognosis.
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spelling pubmed-61577362018-09-26 HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients Burr, Adam R Harari, Paul M Ko, Huaising C Chen, Shuai Yu, Menggang Baschnagel, Andrew M Kimple, Randall J Witek, Matthew E Otorhinolaryngol Head Neck Surg Article OBJECTIVES: Human papillomavirus (HPV) status is a favorable prognostic marker for patients with oropharyngeal squamous cell carcinoma (OPSCC) and non-metastatic head and neck non-OPSCC. We evaluated the impact of HPV status on overall survival (OS) for patients with Stage IVC non-OPSCC. MATERIALS AND METHODS: Patients diagnosed with Stage IVC non-OPSCC and known HPV status between 2010–2013 were identified in the National Cancer Database. Univariate and multivariate analyses were performed to determine factors associated with OS. Propensity score-weighted Kaplan-Meier estimation was used to adjust for confounders in OS analyses. Multiple imputation method was used for sensitivity analysis. RESULTS: We identified 708 patients with Stage IVC non-OPSCC with 30% being HPV-positive. Unadjusted median survival was 10.3 months for HPV-negative patients and 21.4 months for HPV-positive patients (p<0.0001). Age ≥ 65 and tumor diameter were associated with worse OS (p<0.05) while treatment versus no treatment and HPV-positive status were associated with improved OS on multivariate analysis (p<0.001). Adjusted median survival for patients with HPV-negative and HPV-positive disease was 11.1 months and 23.8 months, respectively (p<0.001). On unadjusted subgroup analysis, patients with HPV-positive oral cavity disease exhibited improved outcomes (p<0.0001) while HPV-positive hypopharynx (p<0.06) and larynx (p<0.12) patients exhibited a trend for improved OS compared to HPV-negative patients. The survival advantage associated with HPV positivity was maintained on sensitivity analysis (p<0.01). CONCLUSION: These data demonstrate a clinically meaningful association between HPV status and OS in patients with non-OSPCC presenting with Stage IVC disease. In the absence of randomized data, these findings support active consideration of HPV status in clinical decision making, clinical trial design, and patient counseling regarding prognosis. 2018-02-24 2018 /pmc/articles/PMC6157736/ /pubmed/30271885 Text en http://creativecommons.org/licenses/by/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Article
Burr, Adam R
Harari, Paul M
Ko, Huaising C
Chen, Shuai
Yu, Menggang
Baschnagel, Andrew M
Kimple, Randall J
Witek, Matthew E
HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients
title HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients
title_full HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients
title_fullStr HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients
title_full_unstemmed HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients
title_short HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients
title_sort hpv impacts survival of stage ivc non-oropharyngeal hnscc cancer patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157736/
https://www.ncbi.nlm.nih.gov/pubmed/30271885
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