Nasopharyngeal cancer: Incidence and prognosis of human papillomavirus and Epstein-Barr virus association at a single North American institution

Shannon S Wu; Bonnie Chen; Christopher W Fleming; Akeesha A Shah; Christopher C Griffith; Chaim Domb; Chandana A Reddy; Shauna R Campbell; Neil M Woody; Eric D Lamarre; Robert R Lorenz; Brandon L Prendes; Joseph Scharpf; Larissa Schwartzman; Jessica L Geiger; Shlomo A Koyfman; Jamie A Ku

doi:10.1002/hed.26976

Nasopharyngeal cancer: Incidence and prognosis of human papillomavirus and Epstein-Barr virus association at a single North American institution

Head Neck. 2022 Apr;44(4):851-861. doi: 10.1002/hed.26976. Epub 2022 Jan 18.

Authors

Shannon S Wu¹, Bonnie Chen², Christopher W Fleming³, Akeesha A Shah⁴, Christopher C Griffith⁴, Chaim Domb³, Chandana A Reddy³, Shauna R Campbell³, Neil M Woody³, Eric D Lamarre², Robert R Lorenz², Brandon L Prendes², Joseph Scharpf², Larissa Schwartzman⁵, Jessica L Geiger⁵, Shlomo A Koyfman³, Jamie A Ku²

Affiliations

¹ Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
² Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
³ Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA.
⁴ Department of Pathology, Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.
⁵ Department of Hematology & Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA.

PMID: 35040516
DOI: 10.1002/hed.26976

Abstract

Background: The prognostication of Epstein-Barr virus (EBV) and human papillomavirus (HPV) status in nasopharyngeal cancer (NPC) is unclear.

Methods: This retrospective study analyzed NPC from 2000 to 2019.

Results: Seventy-eight patients were included: 43 EBV⁺ , 12 HPV⁺ , 23 EBV^- /HPV^- , and 0 EBV⁺ /HPV⁺ . All p16⁺ tumors were also positive for HPV-CISH. Baseline characteristics were not different between groups except age, N-classification, and Karnofsky Performance Scale (KPS) (p < 0.05). For EBV⁺ , HPV⁺ , and EBV^- /HPV^- respectively, 3-year overall survival (OS) was 89.9%, 69.8%, and 52.5% (p = 0.006). EBV^- /HPV^- status was significantly associated with worse OS but not freedom from progression (FFP) on univariate analysis, and did not remain a significant predictor of OS after adjusting for KPS, age, and group stage.

Conclusions: EBV⁺ NPC tumors were seen in younger, healthier patients than HPV⁺ and EBV^- tumors, and there were no cases of coinfection. The association of viral status with OS was insignificant after adjusting for KPS and age.

Keywords: Epstein-Barr virus; human papillomavirus; nasopharyngeal cancer; nasopharynx; survival outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alphapapillomavirus*
DNA, Viral
Epstein-Barr Virus Infections* / complications
Epstein-Barr Virus Infections* / epidemiology
Herpesvirus 4, Human / genetics
Humans
Incidence
Nasopharyngeal Neoplasms*
North America
Papillomaviridae / genetics
Papillomavirus Infections* / epidemiology
Prognosis
Retrospective Studies

Substances

DNA, Viral