Matthew H Stenmark1, Dean Shumway1, Cui Guo2, Jeffrey Vainshtein1, Michelle Mierzwa1, Reshma Jagsi1, Jennifer J Griggs3, Mousumi Banerjee2. 1. Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan, U.S.A. 2. Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, U.S.A. 3. Department of Internal Medicine, Hematology and Oncology Division, University of Michigan Medical Center, Ann Arbor, Michigan, U.S.A.
Abstract
OBJECTIVE: Much of what is known about the significance of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma is derived from single-institution retrospective studies, post hoc analyses of tissue specimens from clinical trials, and tissue bank studies with a small sample size. The objective of this study is to investigate the impact of HPV on the frequency and clinical presentation of oropharyngeal carcinoma in a large, national sample with information from patients who underwent HPV testing. STUDY DESIGN: Retrospective, cross-sectional study. METHODS: We identified a comprehensive national sample of 8,359 patients with oropharyngeal carcinoma and known HPV status diagnosed between 2010 and 2011 within the National Cancer Database. Multivariable logistic regression was used to assess correlates of patient and tumor characteristics on HPV status. RESULTS: Among patients with oropharyngeal carcinoma, the frequency of HPV-related squamous cell carcinoma in the United States was 65.4%. HPV-related oropharyngeal carcinoma was associated with younger age, male sex, and white race (P < 0.001). Advanced primary tumor stage was associated with HPV-negative disease (P < 0.001), whereas increasing nodal burden was associated with HPV-positive disease (P < 0.001). Despite less-advanced nodal disease, HPV-negative tumors were associated with a higher likelihood of metastasis at presentation (P < 0.001). CONCLUSION: HPV now accounts for the majority of newly diagnosed oropharyngeal carcinoma in the United States and is associated with a distinct clinical profile, supporting efforts to re-evaluate the staging and treatment paradigm for HPV-associated oropharyngeal cancer. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2270-2278, 2017.
OBJECTIVE: Much of what is known about the significance of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma is derived from single-institution retrospective studies, post hoc analyses of tissue specimens from clinical trials, and tissue bank studies with a small sample size. The objective of this study is to investigate the impact of HPV on the frequency and clinical presentation of oropharyngeal carcinoma in a large, national sample with information from patients who underwent HPV testing. STUDY DESIGN: Retrospective, cross-sectional study. METHODS: We identified a comprehensive national sample of 8,359 patients with oropharyngeal carcinoma and known HPV status diagnosed between 2010 and 2011 within the National Cancer Database. Multivariable logistic regression was used to assess correlates of patient and tumor characteristics on HPV status. RESULTS: Among patients with oropharyngeal carcinoma, the frequency of HPV-related squamous cell carcinoma in the United States was 65.4%. HPV-related oropharyngeal carcinoma was associated with younger age, male sex, and white race (P < 0.001). Advanced primary tumor stage was associated with HPV-negative disease (P < 0.001), whereas increasing nodal burden was associated with HPV-positive disease (P < 0.001). Despite less-advanced nodal disease, HPV-negative tumors were associated with a higher likelihood of metastasis at presentation (P < 0.001). CONCLUSION:HPV now accounts for the majority of newly diagnosed oropharyngeal carcinoma in the United States and is associated with a distinct clinical profile, supporting efforts to re-evaluate the staging and treatment paradigm for HPV-associated oropharyngeal cancer. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2270-2278, 2017.
Authors: R G Roetzheim; N Pal; C Tennant; L Voti; J Z Ayanian; A Schwabe; J P Krischer Journal: J Natl Cancer Inst Date: 1999-08-18 Impact factor: 13.506
Authors: Lalle Hammarstedt; David Lindquist; Hanna Dahlstrand; Mircea Romanitan; Liselotte Onelöv Dahlgren; Jeanna Joneberg; Nomi Creson; Johan Lindholm; Weimin Ye; Tina Dalianis; Eva Munck-Wikland Journal: Int J Cancer Date: 2006-12-01 Impact factor: 7.396
Authors: M L Gillison; W M Koch; R B Capone; M Spafford; W H Westra; L Wu; M L Zahurak; R W Daniel; M Viglione; D E Symer; K V Shah; D Sidransky Journal: J Natl Cancer Inst Date: 2000-05-03 Impact factor: 13.506
Authors: A Blythe Ryerson; Edward S Peters; Steven S Coughlin; Vivien W Chen; Maura L Gillison; Marsha E Reichman; Xiaocheng Wu; Anil K Chaturvedi; Kelly Kawaoka Journal: Cancer Date: 2008-11-15 Impact factor: 6.860
Authors: Carole Fakhry; William H Westra; Sigui Li; Anthony Cmelak; John A Ridge; Harlan Pinto; Arlene Forastiere; Maura L Gillison Journal: J Natl Cancer Inst Date: 2008-02-12 Impact factor: 13.506
Authors: Luke R G Pike; Trevor J Royce; Amandeep R Mahal; Daniel W Kim; William L Hwang; Brandon A Mahal; Nina N Sanford Journal: J Natl Compr Canc Netw Date: 2020-02 Impact factor: 11.908
Authors: Vittoria Guarda; Lea Schroeder; Michael Pawlita; Kristian Ikenberg; Niels J Rupp; Wolfram Jochum; Sandro J Stoeckli; Dana Holzinger; Martina A Broglie Journal: Front Oncol Date: 2022-04-22 Impact factor: 5.738
Authors: Melina J Windon; Gypsyamber D'Souza; Tim Waterboer; Lisa Rooper; William H Westra; Tanya Troy; Drew Pardoll; Marietta Tan; Siddhartha Yavvari; Ana P Kiess; Brett Miles; Wojciech K Mydlarz; Patrick K Ha; Noemi Bender; David W Eisele; Carole Fakhry Journal: Head Neck Date: 2020-02-26 Impact factor: 3.147
Authors: Linda X Yin; Gypsyamber D'Souza; William H Westra; Steven J Wang; Annemieke van Zante; Yuehan Zhang; Eleni M Rettig; William R Ryan; Patrick K Ha; Alicia Wentz; Wayne Koch; David W Eisele; Carole Fakhry Journal: Laryngoscope Date: 2018-03-14 Impact factor: 3.325
Authors: Jie Fan; Peng Li; Qigen Fang; Yang Yang; He Zhang; Wei Du; Shanting Liu; Ruihua Luo Journal: Front Oncol Date: 2022-08-16 Impact factor: 5.738
Authors: Changxing Liu; Guy Talmor; Garren Mi Low; Tiffany V Wang; Daljit S Mann; Uttam K Sinha; Niels C Kokot Journal: Clin Med Insights Ear Nose Throat Date: 2018-08-19