Incidence and survival of HNSCC patients living with HIV compared with HIV-negative HNSCC patients

Katharina Haase; Iris Piwonski; Carmen Stromberger; Nadine Thieme; Max Heiland; Benedicta Beck-Broichsitter; Veit M Hofmann; Grzegorz Kofla; Steffen Sander; Ullrich Keilholz; Konrad Neumann; Katharina Stölzel; Heidi Olze; Philipp Arens; Steffen Dommerich; Annekatrin Coordes

doi:10.1007/s00405-020-06573-9

Incidence and survival of HNSCC patients living with HIV compared with HIV-negative HNSCC patients

Eur Arch Otorhinolaryngol. 2021 Oct;278(10):3941-3953. doi: 10.1007/s00405-020-06573-9. Epub 2021 Jan 25.

Authors

Katharina Haase¹, Iris Piwonski², Carmen Stromberger³, Nadine Thieme⁴, Max Heiland⁵, Benedicta Beck-Broichsitter⁵, Veit M Hofmann⁶, Grzegorz Kofla⁷, Steffen Sander⁸, Ullrich Keilholz⁹, Konrad Neumann¹⁰, Katharina Stölzel¹, Heidi Olze², Philipp Arens¹, Steffen Dommerich¹, Annekatrin Coordes¹¹

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Germany.
² Department of Pathology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany.
³ Department of Radiooncology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany.
⁴ Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany.
⁵ Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Benjamin Franklin, Berlin, Germany.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
⁷ Department of Oncology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany.
⁸ Clinical Cancer Registry, Charité Comprehensive Center (CCCC), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Berlin, Germany.
⁹ Department of Oncology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
¹⁰ Institute for Biometrics and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Charité Mitte, Berlin, Germany.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum and Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Germany. annekatrin.coordes@charite.de.

Abstract

Purpose: The aim was to analyze the incidence and survival of patients living with HIV (PLWH) with head and neck squamous cell carcinoma (HNSCC) and to compare with a control group of HIV-negative HNSCC patients.

Methods: Clinicopathological data and predictors for overall survival (OS) and disease-free survival (DFS) were investigated (2009-2019).

Results: 50 of 5151 HNSCC patients (0.97%) were PLWH, and 76% were smokers. Age ≤ 60 years, HIV-PCR ≤ 50 copies, CD4 cells ≤ 200/mm³, cART treatment, T and UICC classification, oral cavity and nasal/paranasal sinuses, and therapy were significantly associated with OS in univariate analysis. In the multivariate analysis, only age and HIV-PCR independently predicted OS. The OS of the 50 PLWH was not significantly altered compared with the 5101 HIV-negative controls. However, OS and DFS were significantly inferior in advanced tumor stages of PLWH compared with an age-matched control group of 150 HIV-negative patients.

Conclusions: PLWH were diagnosed with HNSCC at a significantly younger age compared to HIV-negative patients. Taking into account patient age at initial diagnosis, both OS and DFS rates in PLWH are significantly worse compared with a matched control group of HIV-negative patients in advanced tumor stages UICC III/IV. The prognosis (OS) is improved when taking cART treatment, the HIV viral load is undetectable and CD4 count is high.

Keywords: HIV; HNSCC; Smoking; Survival; p16.

MeSH terms

HIV Infections* / complications
HIV Infections* / drug therapy
HIV Infections* / epidemiology
Head and Neck Neoplasms* / epidemiology
Head and Neck Neoplasms* / therapy
Humans
Incidence
Middle Aged
Prognosis
Squamous Cell Carcinoma of Head and Neck