Hong Li, Henry S Park, Heather A Osborn, Benjamin L Judson
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Data were extracted from the National Cancer Database (NCDB) of patients diagnosed with OP or OC SCC from 2010 to 2014. Univariate and multivariate survival analyses were conducted with chi-square tests, Kaplan-Meier estimates, log-rank tests, and Cox proportional hazards multivariable modeling.</p><p><strong>Results: </strong>A total of 30,707 patients (13,694 OP HPV-associated, 7933 OP HPV-, 1220 OC HPV-associated, 7860 OC HPV-) were identified. In all four groups, women tended to be older and have lower T and N clinical classification than men. Though there were no significant differences in OS between the sexes in OP HPV-associated cancers, female sex was associated with worse OS in OP HPV- cancers (HR: 1.15; 95% CI 1.04-1.28, <i>p</i> = 0.004), whereas it was associated with improved OS in OC HPV-associated and HPV- cancers (HPV-associated: HR: 0.71; 95% CI 0.50-0.99, <i>p</i> = 0.048; HPV-: HR: 0.87; 95% CI 0.78-0.95, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>The effect of sex on OS in OC and OP SCC appears to vary based on tumor location and HPV status. While the source of this difference in prognostic association is unclear, it may be related to an emerging difference in the biology of HPV carcinogenesis in these locations.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"3 ","pages":"4"},"PeriodicalIF":0.0000,"publicationDate":"2018-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460664/pdf/","citationCount":"0","resultStr":"{\"title\":\"Sex differences in patients with high risk HPV-associated and HPV negative oropharyngeal and oral cavity squamous cell carcinomas.\",\"authors\":\"Hong Li, Henry S Park, Heather A Osborn, Benjamin L Judson\",\"doi\":\"10.1186/s41199-018-0031-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Human papilloma virus (HPV)-associated head and neck cancer is now recognized as a distinct clinical entity from HPV-negative tumors, which are primarily associated with tobacco and alcohol exposure.Little is known, however, about the behavior of HPV-associated oropharynx (OP) and oral cavity (OC) SCCs as two distinct cancers and how sex affects the overall survival (OS) in these two cancers. The objective of our study is to determine if sex is associated with overall survival (OS) in patients with high-risk human papillomavirus (HPV)-positive and HPV-negative squamous cell carcinomas (SCC) in the oropharynx and oral cavity sites.</p><p><strong>Methods: </strong>This is a retrospective cohort study using a national database. Data were extracted from the National Cancer Database (NCDB) of patients diagnosed with OP or OC SCC from 2010 to 2014. Univariate and multivariate survival analyses were conducted with chi-square tests, Kaplan-Meier estimates, log-rank tests, and Cox proportional hazards multivariable modeling.</p><p><strong>Results: </strong>A total of 30,707 patients (13,694 OP HPV-associated, 7933 OP HPV-, 1220 OC HPV-associated, 7860 OC HPV-) were identified. In all four groups, women tended to be older and have lower T and N clinical classification than men. Though there were no significant differences in OS between the sexes in OP HPV-associated cancers, female sex was associated with worse OS in OP HPV- cancers (HR: 1.15; 95% CI 1.04-1.28, <i>p</i> = 0.004), whereas it was associated with improved OS in OC HPV-associated and HPV- cancers (HPV-associated: HR: 0.71; 95% CI 0.50-0.99, <i>p</i> = 0.048; HPV-: HR: 0.87; 95% CI 0.78-0.95, <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>The effect of sex on OS in OC and OP SCC appears to vary based on tumor location and HPV status. While the source of this difference in prognostic association is unclear, it may be related to an emerging difference in the biology of HPV carcinogenesis in these locations.</p>\",\"PeriodicalId\":72518,\"journal\":{\"name\":\"Cancers of the head & neck\",\"volume\":\"3 \",\"pages\":\"4\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460664/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancers of the head & neck\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s41199-018-0031-y\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2018/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancers of the head & neck","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s41199-018-0031-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:与人乳头瘤病毒(HPV)相关的头颈部癌症现在被认为是一种不同于HPV阴性肿瘤的临床实体,后者主要与烟草和酒精暴露有关。然而,人们对与HPV相关的口咽(OP)和口腔(OC)SCC这两种不同癌症的行为以及性别如何影响这两种癌症的总生存率(OS)知之甚少。我们的研究旨在确定口咽部和口腔部位高危人乳头瘤病毒(HPV)阳性和 HPV 阴性鳞状细胞癌(SCC)患者的性别是否与总生存率(OS)相关:这是一项使用国家数据库进行的回顾性队列研究。数据提取自国家癌症数据库(NCDB),涉及2010年至2014年确诊为口咽或口腔癌SCC的患者。通过卡普兰-梅耶估计、对数秩检验和Cox比例危害多变量模型进行了单变量和多变量生存分析:共发现 30707 例患者(13694 例 OP HPV 相关、7933 例 OP HPV-、1220 例 OC HPV 相关、7860 例 OC HPV-)。在所有四组中,女性的年龄往往比男性大,T和N临床分级也比男性低。虽然在 OP HPV 相关癌症中,两性之间的 OS 没有明显差异,但在 OP HPV- 癌症中,女性性别与较差的 OS 有关(HR:1.15;95% CI 1.04-1.28,p = 0.004),而在 OC HPV 相关和 HPV- 癌症中,女性性别与较好的 OS 有关(HPV 相关:HR:0.71;95% CI 1.04-1.28,p = 0.004):HR:0.71;95% CI 0.50-0.99,p = 0.048;HPV-:HR:0.87;95% CI 0.78-0.95,p = 0.004):结论:性别对OC和OP SCC患者OS的影响似乎因肿瘤位置和HPV状态而异。虽然这种预后相关性差异的来源尚不清楚,但它可能与这些部位的 HPV 致癌生物学中新出现的差异有关。
Sex differences in patients with high risk HPV-associated and HPV negative oropharyngeal and oral cavity squamous cell carcinomas.
Background: Human papilloma virus (HPV)-associated head and neck cancer is now recognized as a distinct clinical entity from HPV-negative tumors, which are primarily associated with tobacco and alcohol exposure.Little is known, however, about the behavior of HPV-associated oropharynx (OP) and oral cavity (OC) SCCs as two distinct cancers and how sex affects the overall survival (OS) in these two cancers. The objective of our study is to determine if sex is associated with overall survival (OS) in patients with high-risk human papillomavirus (HPV)-positive and HPV-negative squamous cell carcinomas (SCC) in the oropharynx and oral cavity sites.
Methods: This is a retrospective cohort study using a national database. Data were extracted from the National Cancer Database (NCDB) of patients diagnosed with OP or OC SCC from 2010 to 2014. Univariate and multivariate survival analyses were conducted with chi-square tests, Kaplan-Meier estimates, log-rank tests, and Cox proportional hazards multivariable modeling.
Results: A total of 30,707 patients (13,694 OP HPV-associated, 7933 OP HPV-, 1220 OC HPV-associated, 7860 OC HPV-) were identified. In all four groups, women tended to be older and have lower T and N clinical classification than men. Though there were no significant differences in OS between the sexes in OP HPV-associated cancers, female sex was associated with worse OS in OP HPV- cancers (HR: 1.15; 95% CI 1.04-1.28, p = 0.004), whereas it was associated with improved OS in OC HPV-associated and HPV- cancers (HPV-associated: HR: 0.71; 95% CI 0.50-0.99, p = 0.048; HPV-: HR: 0.87; 95% CI 0.78-0.95, p = 0.004).
Conclusion: The effect of sex on OS in OC and OP SCC appears to vary based on tumor location and HPV status. While the source of this difference in prognostic association is unclear, it may be related to an emerging difference in the biology of HPV carcinogenesis in these locations.