期刊
CANCER
卷 127, 期 14, 页码 2442-2452出版社
WILEY
DOI: 10.1002/cncr.33505
关键词
cohort studies; Head and Neck 5000; human papillomavirus; oropharyngeal cancer; survival
类别
资金
- National Institute for Health Research [RP-PG-0707-10034]
- Above and Beyond, University Hospitals Bristol and Weston Research Capability Funding
- National Institute for Health Research Senior Investigator award
- Cancer Research UK Program Grant, the Integrative Cancer Epidemiology Program [C18281/A19169]
Patients with HPV-driven oropharyngeal cancer generally experience better survival rates, with younger patients showing a more significant advantage in survival. The HPV antibody pattern may also influence survival, independent of antibody levels.
BACKGROUND Patients with human papillomavirus (HPV)-driven oropharyngeal cancer (OPC) experience better survival than those with HPV-negative OPC. It is unclear whether this benefit varies by demographic characteristics and serologic response. METHODS Records from 1411 patients with OPC who had HPV serology data were analyzed. HPV status was based on HPV type 16 (HPV16) E6 serology. Participants were followed for a median of 5.9 years, and Cox proportional hazards models were used to estimate hazard ratios (HRs). The association between HPV status and overall survival was analyzed by age group, sex, smoking status, tumor site, HPV antibody levels, and HPV antibody pattern. Models were adjusted for age, sex, smoking status, and comorbidity. RESULTS For the overall association between HPV status and survival, the fully adjusted HR was 0.43 (95% CI, 0.33-0.56). The HR was 0.19 (95% CI, 0.10-0.35) for participants aged <= 54 years, 0.38 (95% CI, 0.25-0.56) for those aged 55 to 64 years, and 0.73 (95% CI, 0.47-1.13) for those aged >= 65 years (P for interaction = .023). There was no clear evidence for an interaction by sex, smoking status, or tumor site. Survival did not differ according to E6 antibody levels in those who were seropositive. All seropositivity patterns were associated with increased survival compared with a pattern of seronegativity for all antibodies. Patients who are positive for E1, E2, E6, and E7 may experience better survival. CONCLUSIONS HPV status confers a survival advantage across all groups. This survival advantage is more marked for younger patients. The HPV antibody pattern, but not the antibody level, may also affect survival.
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