Surrogate for oropharyngeal cancer HPV status in cancer database studies

Head Neck. 2017 Dec;39(12):2494-2500. doi: 10.1002/hed.24921. Epub 2017 Sep 30.

Abstract

Background: The utility of cancer databases for oropharyngeal cancer studies is limited by lack of information on human papillomavirus (HPV) status. The purpose of this study was to develop a surrogate that can be used to adjust for the effect of HPV status on survival.

Methods: The study cohort included 6419 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012, identified in the National Cancer Database (NCDB). The HPV surrogate score was developed using a logistic regression model predicting HPV-positive status.

Results: The HPV surrogate score was predictive of HPV status (area under the curve [AUC] 0.73; accuracy of 70.4%). Similar to HPV-positive tumors, HPV surrogate positive tumors were associated with improved overall survival (OS; hazard ratio [HR] 0.73; 95% confidence interval [CI] 0.59-0.91; P = .005), after adjusting for important covariates.

Conclusion: The HPV surrogate score is useful for adjusting for the effect of HPV status on survival in studies utilizing cancer databases.

Keywords: National Cancer Database (NCDB); cancer database; human papillomavirus (HPV); oropharyngeal cancer; surrogate marker.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Biopsy, Needle
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / virology*
  • Cohort Studies
  • Database Management Systems / statistics & numerical data*
  • Disease-Free Survival
  • Female
  • Humans
  • Immunohistochemistry
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / therapy
  • Oropharyngeal Neoplasms / virology*
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / mortality
  • Papillomavirus Infections / pathology*
  • Papillomavirus Infections / physiopathology
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • SEER Program
  • Survival Analysis
  • United States

Substances

  • Biomarkers