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

Huaising C. Ko, Paul M. Harari, Ryan M. Sacotte, Shuai Chen, Aaron M. Wieland, Menggang Yu, Andrew M. Baschnagel, Justine Y. Bruce, Randall J. Kimple, Matthew E. Witek

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)2341-2350
Number of pages10
JournalJournal of Cancer Research and Clinical Oncology
Volume143
Issue number11
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Fingerprint

Survival
Carcinoma, squamous cell of head and neck
Multivariate Analysis
Databases
Propensity Score
Survival Analysis
Comorbidity
Neoplasms
Logistic Models
Clinical Trials
Mortality

Keywords

  • Head and neck cancer
  • Human papillomavirus
  • Non-oropharyngeal
  • Squamous cell carcinoma
  • Survival outcomes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas. / Ko, Huaising C.; Harari, Paul M.; Sacotte, Ryan M.; Chen, Shuai; Wieland, Aaron M.; Yu, Menggang; Baschnagel, Andrew M.; Bruce, Justine Y.; Kimple, Randall J.; Witek, Matthew E.

In: Journal of Cancer Research and Clinical Oncology, Vol. 143, No. 11, 01.11.2017, p. 2341-2350.

Research output: Contribution to journalArticle

Ko, Huaising C. ; Harari, Paul M. ; Sacotte, Ryan M. ; Chen, Shuai ; Wieland, Aaron M. ; Yu, Menggang ; Baschnagel, Andrew M. ; Bruce, Justine Y. ; Kimple, Randall J. ; Witek, Matthew E. / Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas. In: Journal of Cancer Research and Clinical Oncology. 2017 ; Vol. 143, No. 11. pp. 2341-2350.
@article{be062b40494347239ba1eb446acdd3b2,
title = "Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas",
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.",
keywords = "Head and neck cancer, Human papillomavirus, Non-oropharyngeal, Squamous cell carcinoma, Survival outcomes",
author = "Ko, {Huaising C.} and Harari, {Paul M.} and Sacotte, {Ryan M.} and Shuai Chen and Wieland, {Aaron M.} and Menggang Yu and Baschnagel, {Andrew M.} and Bruce, {Justine Y.} and Kimple, {Randall J.} and Witek, {Matthew E.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1007/s00432-017-2481-8",
language = "English (US)",
volume = "143",
pages = "2341--2350",
journal = "Journal of Cancer Research and Clinical Oncology",
issn = "0171-5216",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas

AU - Ko, Huaising C.

AU - Harari, Paul M.

AU - Sacotte, Ryan M.

AU - Chen, Shuai

AU - Wieland, Aaron M.

AU - Yu, Menggang

AU - Baschnagel, Andrew M.

AU - Bruce, Justine Y.

AU - Kimple, Randall J.

AU - Witek, Matthew E.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - 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.

AB - 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.

KW - Head and neck cancer

KW - Human papillomavirus

KW - Non-oropharyngeal

KW - Squamous cell carcinoma

KW - Survival outcomes

UR - http://www.scopus.com/inward/record.url?scp=85026921194&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026921194&partnerID=8YFLogxK

U2 - 10.1007/s00432-017-2481-8

DO - 10.1007/s00432-017-2481-8

M3 - Article

C2 - 28752235

AN - SCOPUS:85026921194

VL - 143

SP - 2341

EP - 2350

JO - Journal of Cancer Research and Clinical Oncology

JF - Journal of Cancer Research and Clinical Oncology

SN - 0171-5216

IS - 11

ER -