Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Mar 25, 2023
Date Accepted: Jul 25, 2023
(closed for review but you can still tweet)
Cause of Death in Oropharyngeal Carcinoma Patients by Human Papillomavirus Status: Comparative Data Analysis
ABSTRACT
Background:
Limited studies have assessed the competing causes of death (COD) by human papillomavirus (HPV) status in oropharyngeal squamous cell carcinomas (OPSCC) patients. Identifying the competing COD can help optimize follow-up and therapeutic strategies OPSCC according to different HPV status.
Objective:
To analyze the distribution of the competing causes of death according to HPV status in OPSCC.
Methods:
We retrospectively included stage I-IVB OPSCC patients from the Surveillance, Epidemiology, and End Results database. The association between HPV status and head and neck cancer-specific mortality (HNCSM), second primary cancer mortality (SPCM), and noncancer-caused mortality (NCCM) were analyzed. Chi-squared test, Kaplan-Meier method, and Fine and Gray model were used for statistical analysis.
Results:
We included 5852 patients in this study and 73.2% (n=4283) of them were HPV-related tumors. A total of 1537 (26.3%) patients died, including 789 (51.3%), 333 (21.7%), and 415 (27.0%) patients who died from head and neck cancer, second cancer, and non-cancer causes, respectively. Patients with HPV-positive disease had a significantly lower risk of HNCSM (P<.001) and overall mortality (P<.001) than those with HPV-negative disease. The 5-year head and neck cancer-specific survival was 73.1% and 89.3% in HPV-negative and HPV-positive tumors, respectively (P<.001). The 5-year overall survival was 73.1% and 89.3% in those with HPV-negative and HPV-positive tumors, respectively (P<.001). Patients with HPV-negative tumors had higher HNCSM (P<.001), SPCM (P<.001), and NCCM (P<.001) than patients with HPV-positive tumors using competing-risks regression.
Conclusions:
HPV-positive OPSCC has a lower HNCSM, SPCM, and NCCM than those with HPV-negative OPSCC. Our finding supports the need to tailor patient follow-up according to HPV status in OPSCC patients.
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