Nasopharyngeal cancer: Incidence and prognosis of human papillomavirus and Epstein-Barr virus association at a single North American institution

Background The prognostication of Epstein-Barr virus (EBV) and human papillomavirus (HPV) status in nasopharyngeal cancer (NPC) is unclear. Methods This retrospective study analyzed NPC from 2000 to 2019. Results Seventy-eight patients were included: 43 EBV+, 12 HPV+, 23 EBV-/HPV-, and 0 EBV+/HPV+. All p16(+) tumors were also positive for HPV-CISH. Baseline characteristics were not different between groups except age, N-classification, and Karnofsky Performance Scale (KPS) (p < 0.05). For EBV+, HPV+, and EBV-/HPV- respectively, 3-year overall survival (OS) was 89.9%, 69.8%, and 52.5% (p = 0.006). EBV-/HPV- status was significantly associated with worse OS but not freedom from progression (FFP) on univariate analysis, and did not remain a significant predictor of OS after adjusting for KPS, age, and group stage. Conclusions EBV+ NPC tumors were seen in younger, healthier patients than HPV+ and EBV- tumors, and there were no cases of coinfection. The association of viral status with OS was insignificant after adjusting for KPS and age.

Automated summary

The prognostic significance of Epstein-Barr virus (EBV) and human papillomavirus (HPV) status in nasopharyngeal cancer (NPC) remains unclear. This retrospective study analyzed NPC cases from 2000 to 2019 and found that EBV+ NPC tumors were seen in younger, healthier patients compared to HPV+ and EBV- tumors. The association of viral status with overall survival (OS) was insignificant after adjusting for age and Karnofsky Performance Scale (KPS).