Impact of HIV status on overall survival in head and neck cancers by anatomical site and stage: A multi-center cohort study

IF 3.9 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-06-28 DOI:10.1016/j.oraloncology.2025.107446

Devesh S. Malgave , Christine M. Hartman , Jennifer R. Kramer , Peter A. Richardson , Efthalia Zafeiropoulou , Yongquan Dong , Adovich S. Rivera , Rulin C. Hechter , Lori C. Sakoda , Matthew J. Boyer , Angela Mazul , Yvonne M. Mowery , Donna L. White , Wendy A. Leyden , Michael J. Silverberg , Elizabeth Y. Chiao

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引用次数: 0

Abstract

Objectives

People with human immunodeficiency virus (PWH) are at higher risk for head and neck cancer (HNC) than people without HIV (PWoH), but data on the survival effect of HIV are scarce. The objective is to compare survival for PWH vs. PWoH diagnosed with HNC, stratified by anatomical site and cancer stage.

Materials and Methods

The multi-institutional U.S.-based retrospective analysis included HNC patients (296 PWH and 29,875 PWoH) diagnosed between 2008 and 2020. Statistical analysis reported 5-year overall survival and hazard ratios (HR) for all-cause mortality by HIV infection and CD4 counts for oropharyngeal cancer (OPC), oral cavity cancer (OC), and laryngeal and hypopharyngeal cancers (LHPC); with additional analysis stratified by HPV status and stage (I–IVB).

Results

Compared with PWoH, PWH were likely younger (median [IQR], 60[54–65] vs. 64[59–70] years; p < 0.001), male (98 % vs. 93 %; p = 0.003), black (39 % vs. 13 %; p < 0.001); and HPV+ tumors (25 % vs. 21 %; p = 0.041). The Kaplan–Meier mean survival in years for PWH versus PWoH were 3.41 vs. 3.78 for OPC, 3.78 vs. 3.40 for OC, and 3.50 vs. 3.44 for LHPC. In adjusted analysis, HIV-infection was associated with 43 % higher hazard of death for OPC (HR: 1.43 [95 % CI, 1.08–1.90]) but not associated with OC (HR: 0.74 [0.40–1.12]) and LHPC (HR: 0.98 [0.72–1.34]). For HPV-stratified analysis, higher hazards for both HPV+ (45 %) and HPV- (70 %) tumors. Similar trends were observed in stage-stratified and CD-based analyses.

Conclusion and Relevance

HIV’s association with poorer survival in OPC warrants further research to understand the factors contributing to this survival gap.

查看原文本刊更多论文

一项多中心队列研究：HIV状态对头颈癌解剖部位和分期的总体生存的影响

目的人类免疫缺陷病毒（PWH）感染者罹患头颈癌（HNC）的风险高于非HIV感染者（PWoH），但有关HIV对患者生存影响的数据很少。目的是比较PWH和诊断为HNC的PWoH的生存率，按解剖部位和癌症分期分层。材料和方法基于美国的多机构回顾性分析包括2008年至2020年间诊断的HNC患者（296例PWH和29875例PWoH）。统计分析报告了口咽癌（OPC）、口腔癌（OC）、喉癌和下咽癌（LHPC）的5年总生存率和由HIV感染引起的全因死亡率的风险比（HR）和CD4计数；并根据HPV状态和分期（I-IVB）进行分层分析。结果与PWoH相比，PWH患者可能更年轻(中位数[IQR]， 60[54-65]对64[59-70]岁；p & lt;0.001)，男性(98%对93%；P = 0.003)，黑色(39% vs. 13%；p & lt;0.001);HPV+肿瘤（25% vs 21%）；p = 0.041)。OPC的PWH和PWoH的Kaplan-Meier平均生存年分别为3.41和3.78，OC分别为3.78和3.40，LHPC分别为3.50和3.44。在校正分析中，hiv感染与OPC的死亡风险增加43%相关（HR: 1.43 [95% CI, 1.08-1.90]），但与OC （HR: 0.74[0.40-1.12]）和LHPC （HR: 0.98[0.72-1.34]）无关。对于HPV分层分析，HPV+(45%)和HPV-(70%)肿瘤的危险性更高。在分期分层和基于cd的分析中也观察到类似的趋势。结论和相关性hiv与OPC患者较差生存率的关系值得进一步研究，以了解导致这种生存差距的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.