Trends in HPV Testing for Patients With Sinonasal Squamous Cell Carcinoma: A National Analysis

2021 ◽  
pp. 019459982110675
Author(s):  
Christopher C. Tseng ◽  
Jeff Gao ◽  
Gregory L. Barinsky ◽  
Christina H. Fang ◽  
Wayne D. Hsueh ◽  
...  

Objective The objective of this study was to analyze national trends in human papillomavirus (HPV) testing for patients diagnosed with sinonasal squamous cell carcinoma (SNSCC). Study Design Retrospective database study. Setting National Cancer Database (2010-2016). Methods Cases from 2010 to 2016 with a primary SNSCC diagnosis and known HPV testing status were extracted from the National Cancer Database. Univariate and multivariate analyses were then performed to assess differences in socioeconomic, hospital, and tumor characteristics between tested and nontested patients. Results A total of 2308 SNSCC cases were collected, with 1210 (52.4%) HPV tested and 1098 (47.6%) not tested. On univariate analyses, patient age, insurance, income quartile, population density, treatment facility location, and tumor grade were significantly associated with HPV testing status. After multivariate logistic regression modeling, living in a suburban area had lower odds of HPV testing as compared with living in urban areas (odds ratio, 0.74 [95% CI, 0.55-0.99]; P = .041), while tumor grade III/IV had higher odds than grade I (odds ratio, 1.73 [95% CI, 1.29-2.33]; P < .001). HPV-tested patients had a similar 5-year overall survival to nontested patients (48.3% vs 45.3%, log-rank P = .405). A sharp increase in HPV testing rates was observed after 2010 ( P < .001). Conclusion Among patients with SNSCC, those with high-grade tumors were more likely to be tested for HPV, while patients with a suburban area of residence were less likely. Additionally, there was no significant survival benefit to HPV testing, with tested and nontested groups having similar overall survival. Level of evidence 4.

2020 ◽  
pp. 019459982097617
Author(s):  
Bharat A. Panuganti ◽  
Andrey Finegersh ◽  
Mitchell Flagg ◽  
Xin Tu ◽  
Ryan Orosco ◽  
...  

Objective To explore the survival implications of human papillomavirus (HPV) positivity and subtype in larynx cancer through a national cancer database. To investigate staging discrepancies in larynx cancer associated with HPV status. Study Design Retrospective observational cohort study. Setting National Cancer Database. Methods Data were extracted concerning adults with known HPV status who were treated between 2010 and 2016 for laryngeal squamous cell carcinoma. Patients without known HPV subtype were excluded. Cox multivariable regression models were fit to evaluate the survival impact of HPV status, characterized as a binary variable (HPV+ vs HPV–) and by subtype. Two- and 5-year survival rates were calculated via the Kaplan-Meier method and compared by stage between the HPV+ and HPV– cohorts per the log-rank test. Results Patients with HPV+ larynx cancer were younger (60.5 vs 64.3 years, P < .001), more likely to have private insurance (37.2% vs 31.2%, P < .001), more commonly White (84.6% vs 82.4%, P = .013), and more likely to present with nodal disease (42.6% vs 33.0%, P < .001). HPV positivity and HPV subtype 16 were associated with improved overall survival. One-stage discrepancies in 5-year survival were observed between the HPV+ and HPV– cohorts: stage II HPV+ (69.45%) vs stage I HPV– (65.77%); stage IV HPV+ (47.67%) vs stage III HPV– (46.80%). Conclusions HPV positivity and infection with HPV subtype 16 are correlated with improved overall survival in patients with laryngeal squamous cell carcinoma, manifesting with a 1-stage incremental survival advantage. Future prospective studies are indicated to corroborate the findings from this large-population database retrospective study.


2017 ◽  
Vol 158 (2) ◽  
pp. 309-318 ◽  
Author(s):  
Suat Kılıç ◽  
Sarah S. Kılıç ◽  
Kajal P. Shah ◽  
Jean Anderson Eloy ◽  
Soly Baredes ◽  
...  

Objective To determine the frequency, associated factors, and prognosis of clinicopathologic stage discrepancy in oropharyngeal squamous cell carcinoma (OPSCC). Study Design Retrospective study using a national database. Setting National Cancer Database. Subjects and Methods Cases of OPSCC diagnosed between January 1, 2004, and December 31, 2013, with full clinical and pathologic staging information available were identified. Demographic, clinicopathologic, and treatment variables associated with overall stage discrepancy were identified by multivariate logistic regression analysis. Results In total, 7731 cases of OPSCC were identified. Overall stage discrepancy was present in 30.2% of cases (21.9% upstaging, 8.2% downstaging). A total of 13.1% of cases were T-upstaged, and 10.5% of cases were T-downstaged; 22.9% of cases were N-upstaged, and 8.6% of cases were N-downstaged. Upstaging by overall stage was associated with a high Charlson-Deyo score, high tumor grade, number of lymph nodes examined, and increasing tumor size. No factors were positively associated with downstaging. High tumor grade was negatively associated with downstaging. For stage II, III, and IVA tumors, upstaging was associated with poorer OS. Conclusion Clinicopathologic stage discrepancy is common in OPSCC and is likely attributable to insensitive clinical staging techniques as well as to intrinsic tumor biologic properties. Upstaging is associated with poorer prognosis, which is likely due to advancement of disease.


2021 ◽  
pp. 019459982110675
Author(s):  
Jerome M. Karp ◽  
Kenneth S. Hu ◽  
Michael Persky ◽  
Mark Persky ◽  
Adam Jacobson ◽  
...  

Objective Sinonasal cancer often presents as locoregionally advanced disease. National guidelines recommend management of stage T4b tumors with systemic therapy and radiotherapy, but recent studies suggest that including surgical resection in the multimodal treatment of these tumors may improve local control and survival. We queried the National Cancer Database to examine patterns of care and outcomes in T4b sinonasal squamous cell carcinoma (SCC). Study Design Prospectively gathered data. Setting National Cancer Database. Methods Patients with T4b N0-3 M0 sinonasal squamous cell carcinoma diagnosed in 2004 to 2016 were stratified between those who received chemoradiotherapy and those who underwent surgical resection with neoadjuvant or adjuvant treatment. The overall survival of each cohort was assessed via Kaplan-Meier analysis and Cox proportional hazard models, with repeat analysis after reweighting of data via inverse probability of treatment weighting. Results Among 805 patients included in analysis, 2-year overall survival for patients undergoing surgical resection was 60.8% (95% CI, 56.1%-65.9%), while for patients undergoing chemoradiotherapy it was 46.7% (95% CI, 41.9%-52.0%). On Cox regression analysis, the inclusion of surgery in management was associated with improved survival in univariate analysis (hazard ratio [HR], 0.723 [95% CI, 0.606-0.862]; P < .001) and multivariate analysis (HR, 0.739 [95% CI, 0.618-0.885]; P = .001). Results with reweighted data were consistent in univariate analysis (HR, 0.765 [95% CI, 0.636-0.920]; P = .004]). Conclusion Surgical treatment with neoadjuvant or adjuvant treatment for stage T4b sinonasal SCC was associated with promising survival outcomes, suggesting a role for incorporating surgery in treatment of select T4b SCC, particularly when removal of all macroscopic disease is feasible.


2021 ◽  
Author(s):  
Yinghua Li ◽  
Zihao Chen ◽  
Lu Chen ◽  
Weizhong Li

Abstract BackgroundTongue squamous cell carcinoma (TSCC) is one of the most common oral squamous cell carcinoma (OSCC) with a high occurrence and a poor prognosis, yet its molecular mechanisms are largely unknown and novel drug candidates are needed. The purpose of this study was to construct gene co-expression networks to identify hub proteins significantly associated with tumor grades and the overall survival (OS) of TSCC patients and provide potential drug candidates. MethodsThe mRNA-sequencing and clinical data were obtained from The Cancer Genome Atlas (TCGA) dataset. Weighted gene co-expression network analysis (WGCNA) was used for identifying the co-expression module related to the tumor grade of TSCC. The hub proteins were selected by the interaction number with other proteins, and their correlations with prognosis and tumor grades were calculated. Virtual screening of compounds by the hub protein structures was used to identify the drug candidates. ResultsWGCNA identified ten co-expression modules, in which the brown module consisted of 163 genes was most significantly correlated with the tumor grade. Six hub genes/proteins (BUB1, CCNB2, CDC6, CDC20, CDK1, and MCM2) tended to be in the central hub of the network. And higher expression levels of these hub genes were associated with tumor grades and worse overall survival. Three compounds, targeting hub proteins, demonstrated high binding affinities, favorable pharmacologic properties, and low toxicity. Conclusion The gene co-expression network-based study could provide additional insight into tumorigenesis and progression of TSCC, and our study might provide novel drug candidates.


2018 ◽  
Vol 159 (3) ◽  
pp. 456-465 ◽  
Author(s):  
Stacey M. Davidson ◽  
Huasing C. Ko ◽  
Paul M. Harari ◽  
Aaron M. Wieland ◽  
Shuai Chen ◽  
...  

Objective We evaluated the ability of the American Joint Committee on Cancer (AJCC) seventh edition staging system to prognosticate the overall survival of patients with human papillomavirus (HPV)–positive laryngeal squamous cell carcinoma. Study Design Retrospective analysis. Setting National Cancer Database. Subjects and Methods Patients diagnosed with laryngeal squamous cell carcinoma who were treated with curative intent were identified in the National Cancer Database. Multivariate analysis was utilized to determine factors correlated with overall survival in the HPV-negative and HPV-positive cohorts. Unadjusted and propensity score–weighted Kaplan-Meier estimation was used to determine overall survival of HPV-negative and HPV-positive patients across AJCC stage groupings. Results We identified 3238 patients with laryngeal squamous cell carcinoma, of which 2812 were HPV negative and 426 were HPV positive. Overall survival adjusted for age, sex, and comorbidity status confirmed significant differences among all consecutive stage groupings (I vs II, P < .001; II vs III, P < .05; III vs IVA, P < .001; IVA vs IVB, P < .05) in the HPV-negative cohort, whereas only stages IVAs and IVB ( P < .01) exhibited a significant difference in overall survival for HPV-positive patients. Conclusion The current AJCC staging system does not accurately distinguish risk of mortality for patients with HPV-positive disease. These data support the consideration of HPV status in estimating prognosis as well as clinical trial design and clinical decision making for patients with laryngeal squamous cell carcinoma.


Author(s):  
Asmaa Ali Hussein

Squamous cell carcinoma characterized by poor prognosis due to aggressive tumor growth and dissemination high rate of tumor cell . age ranged of patient case included in the study 40-62 years and mean age 55±99. The sex distribution male/female ratio 1:1. Male case 15 and female 15 of the present study The results of clinical forums showed in the current study was endophytic 10(33.3%) in the same time Exophytic were presented in 20 cases (76.7%). Regarding distribution of the tumors site, the preponderance of them 19 cases 73.3% were located alveolar mucosa, followed by in the tongue 11 cases(36.7%) Tumor stage was analyzed and recorded in Oral squamous cell carcinoma included cases, the preponderance of them were Stage II 11 cases 36.7% followed by stage III 10 cases 33.3% , 9 cases 30.0% were stage I. While Concerning tumor grade, majority of them 15 cases 50% had grade II moderately differentiated SCC, while 11 cases 36.7% had grade III poorly differentiated SCC and 4 cases 13.3% had grade I well differentiated SCC Positive TGF-β3 immunostaining was detected as cell with staining brown color, all tissues sections included show Positive expression based on IHC teqnique. Positive Transforming Growth Factor TGF-β3 Immuno staining was found in all case results and display that 4 samples with percentage 13.3% expressed strong positive 87.67 ± 1.45 expression , 11cases 36.7% showed 51.33 ±0.88 positive expression moderate at the same time 15 samples 50.0% showed positive weak expression.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qi-Fan Yang ◽  
Di Wu ◽  
Jian Wang ◽  
Li Ba ◽  
Chen Tian ◽  
...  

AbstractLung squamous cell carcinoma (LUSC) possesses a poor prognosis even for stages I–III resected patients. Reliable prognostic biomarkers that can stratify and predict clinical outcomes for stage I–III resected LUSC patients are urgently needed. Based on gene expression of LUSC tissue samples from five public datasets, consisting of 687 cases, we developed an immune-related prognostic model (IPM) according to immune genes from ImmPort database. Then, we comprehensively analyzed the immune microenvironment and mutation burden that are significantly associated with this model. According to the IPM, patients were stratified into high- and low-risk groups with markedly distinct survival benefits. We found that patients with high immune risk possessed a higher proportion of immunosuppressive cells such as macrophages M0, and presented higher expression of CD47, CD73, SIRPA, and TIM-3. Moreover, When further stratified based on the tumor mutation burden (TMB) and risk score, patients with high TMB and low immune risk had a remarkable prolonged overall survival compared to patients with low TMB and high immune risk. Finally, a nomogram combing the IPM with clinical factors was established to provide a more precise evaluation of prognosis. The proposed immune relevant model is a promising biomarker for predicting overall survival in stage I–III LUSC. Thus, it may shed light on identifying patient subset at high risk of adverse prognosis from an immunological perspective.


Author(s):  
Roberto Milazzotto ◽  
Rocco Luca Emanuele Liardo ◽  
Giuseppe Privitera ◽  
Luigi Raffaele ◽  
Vincenzo Salamone ◽  
...  

Abstract Aim: Conjunctival squamous cell carcinoma (SCC) is a rare tumour of the ocular region and microscopic radical surgical is difficult. There are no single guidelines for therapeutic management and the role of radiation therapy is not clearly defined although conventionally photon or electron beams are used. Proton beam radiotherapy (PBRT) is a new option for a conservative approach and allows good sparing of the organs at risk. Materials and methods: After surgical resection, we collected 15 cases treated at our institution with PBRT. The dose delivered was between 48 and 60 Gy relative biological effectiveness (RBE), with fractions of 12–15 Gy RBE. Results: After an average period of 48 months, the patients achieved excellent disease control (overall survival and disease-free survival: 86·6%), with minimal acute and late toxicity. Findings: In this work, we present our experience on the use of PBRT technique in SCC treatment. A larger sample of patients is needed to draw conclusions about the impact of this treatment on disease recurrence and overall survival.


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