TY - JOUR
T1 - Human papillomavirus-related squamous cell carcinoma of the oropharynx
T2 - A comparative study in whites and African Americans
AU - Chernock, Rebecca D.
AU - Zhang, Qin
AU - El-Mofty, Samir K.
AU - Thorstad, Wade L.
AU - Lewis, James S.
PY - 2011/2
Y1 - 2011/2
N2 - Objectives: To evaluate the frequency of human papillomavirus-related oropharyngeal squamous cell carcinoma in African Americans and whites and to examine patient outcomes in these 2 groups. Design: Retrospective study. Setting: One tertiary care, university medical center. Patients: Information on patients with stage III/IV oropharyngeal squamous cell carcinoma diagnosed between 1998 and 2007, and with primary surgical samples available for review, were selected from a radiotherapy database. One patient was Native American and was excluded from analysis; data on 174 patients were analyzed. Results: One hundred forty-eight patients (85.1%) were white and 26 (14.9%) were African American. Human papillomavirus in situ hybridization-positive and p16-positive tumors were much more common in whites (63.5% and 83.1% of tumors, respectively) than in African Americans (11.5% and 34.6% of tumors, respectively) (P<.001). African Americans were also more likely to have received definitive (nonsurgical) rather than postoperative radiation therapy (P=.001) and had a higher frequency of T3/T4-stage tumors (P=.03) compared with whites. Disease-free survival was significantly shorter for African Americans (P=.02). In multivariate analysis, viral status (P=.006), T stage (P=.02), and treatment type (P=.002), but not race (P=.98), were significant factors contributing to disease-free survival. Conclusions: In high-stage oropharyngeal squamous cell carcinoma, the proportion of human papillomavirus-related tumors is much higher in whites than in African Americans. African Americans also appear to develop higher T-stage tumors and are more likely to receive definitive therapy. The shorter disease-free survival observed in African Americans may be due to viral status, treatment type, and higher T stage, but does not appear to be due to race.
AB - Objectives: To evaluate the frequency of human papillomavirus-related oropharyngeal squamous cell carcinoma in African Americans and whites and to examine patient outcomes in these 2 groups. Design: Retrospective study. Setting: One tertiary care, university medical center. Patients: Information on patients with stage III/IV oropharyngeal squamous cell carcinoma diagnosed between 1998 and 2007, and with primary surgical samples available for review, were selected from a radiotherapy database. One patient was Native American and was excluded from analysis; data on 174 patients were analyzed. Results: One hundred forty-eight patients (85.1%) were white and 26 (14.9%) were African American. Human papillomavirus in situ hybridization-positive and p16-positive tumors were much more common in whites (63.5% and 83.1% of tumors, respectively) than in African Americans (11.5% and 34.6% of tumors, respectively) (P<.001). African Americans were also more likely to have received definitive (nonsurgical) rather than postoperative radiation therapy (P=.001) and had a higher frequency of T3/T4-stage tumors (P=.03) compared with whites. Disease-free survival was significantly shorter for African Americans (P=.02). In multivariate analysis, viral status (P=.006), T stage (P=.02), and treatment type (P=.002), but not race (P=.98), were significant factors contributing to disease-free survival. Conclusions: In high-stage oropharyngeal squamous cell carcinoma, the proportion of human papillomavirus-related tumors is much higher in whites than in African Americans. African Americans also appear to develop higher T-stage tumors and are more likely to receive definitive therapy. The shorter disease-free survival observed in African Americans may be due to viral status, treatment type, and higher T stage, but does not appear to be due to race.
UR - http://www.scopus.com/inward/record.url?scp=79952012419&partnerID=8YFLogxK
U2 - 10.1001/archoto.2010.246
DO - 10.1001/archoto.2010.246
M3 - Article
C2 - 21339403
AN - SCOPUS:79952012419
SN - 0886-4470
VL - 137
SP - 163
EP - 169
JO - Archives of Otolaryngology - Head and Neck Surgery
JF - Archives of Otolaryngology - Head and Neck Surgery
IS - 2
ER -