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Int Forum Allergy Rhinol. 2017 Oct;7(10):980-989. doi: 10.1002/alr.21996. Epub 2017 Aug 31.

Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.
2
Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, NJ.
3
Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ.
4
Department of Otolaryngology, Harvard Medical School, Boston, MA.
5
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA.
6
Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, NJ.
7
Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ.

Abstract

BACKGROUND:

The role of human papillomavirus (HPV) in sinonasal squamous cell carcinoma (SNSCC) is not well understood.

METHODS:

The National Cancer Database was queried for cases of SNSCC with known HPV status. Demographics, socioeconomic variables, TNM stage, histology, grade, treatment modalities, and overall survival (OS) through 5 years were compared between HPV-positive and HPV-negative tumors. Cox proportional hazard regression analyses were performed.

RESULTS:

Seven hundred seventy (770) cases were identified; 526 were HPV-negative (68.3%) and 244 (31.7%) were HPV-positive. Patients with HPV-positive tumors were younger (58.0 vs 63.7 years, p < 0.0001). Nasal cavity (49.4%) tumors were more likely to be HPV-positive (p < 0.05) than maxillary (18.8%), ethmoid (18.8%), and frontal (18.2%) sinus tumors. Large cell nonkeratinizing (42.4%), papillary (42.1%), and basaloid (56.5%) tumors were more likely than keratinizing (25.2%) tumors to be HPV-positive (p < 0.05). Well-differentiated (grade I) tumors (9.0%) were less likely than higher grade tumors to be HPV-positive (p < 0.05). Gender, race, facility type, insurance type, median income, education level, Charlson-Deyo comorbidity score, overall stage, T stage, N stage, M stage, tumor size, treatment modality, surgical approach, and surgical margins did not vary by HPV status (p ≥ 0.05). HPV-positive tumors had higher OS than HPV-negative tumors (p < 0.0001). At 5 years, OS was 68.1% and 51.5% for HPV-positive and HPV-negative tumors, respectively. On multivariate analyses, HPV positivity remained a favorable prognostic factor (hazard ratio, 0.49; 95% confidence interval, 0.34-0.70).

CONCLUSION:

HPV positivity is more common in nasal cavity SCC and nonkeratinizing SNSCC. It is also a favorable prognostic factor in SNSCC. Future studies on SNSCC should take HPV positivity into consideration.

KEYWORDS:

HPV; NCDB; National Cancer Database; human papillomavirus; sinonasal cancer; sinus; squamous cell carcinoma; survival

PMID:
28859244
DOI:
10.1002/alr.21996
[Indexed for MEDLINE]

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