Biologic and behavioral associations of estrogen receptor alpha positivity in head and neck squamous cell carcinoma

Objectives: Tumor HPV status is an established independent prognostic marker for oropharynx cancer (OPC). Recent studies have reported that tumor estrogen receptor alpha (ER alpha) positivity is also associated with prognosis independent of HPV. Little is known about the biologic and behavioral predictors of ER alpha positivity in head and neck squamous cell cancer (HNSCC). We therefore explored this in a multicenter prospective cohort study. Materials and Methods: Participants with HNSCC completed a survey and provided a blood sample. Tumor samples were tested for ER alpha using immunohistochemistry. ER alpha positivity was defined as T2, OR = 3.6, 95% CI 1.9-7.1), male sex (OR = 2.0, 95% CI 1.1-3.6), overweight/obesity (BMI 25, OR = 1.9, 95% CI 1.1-3.3), and those married/living with a partner (OR = 1.7, 95% CI 1.0-3.0). In a multivariate model, HPV-positivity (aOR = 27.5, 95% CI 11.4-66) and small tumor size (

Automated summary

The study revealed that HPV positivity and small tumor size are significant predictors of ER alpha positivity in HNSCC. Male sex, overweight/obesity, and being married/living with a partner may also be associated with ER alpha positivity.