Contemporary, Multifactorial Sociodemographic Assessment of Prognosis Predictors Across HPV+/– Nasopharyngeal Carcinomas

Sunday, October 1, 2023

1:00 PM - 1:06 PM East Coast USA Time

Location: 201AB

Presenting Author(s)

David J. Fei-Zhang, BA

MD-MBA Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States

Co-Author(s)

David J. Fei-Zhang, BA

MD-MBA Student
Northwestern University - Feinberg School of Medicine
Chicago, IL, United States

Co-Author(s)

Daniel C. Chelius, MD

Associate Professor
Baylor College of Medicine / Texas Children's Hospital
Houston, TX, United States

Co-Author(s)

Urjeet A. Patel, MD

Associate Professor
Department of Otolaryngology-- Head and Neck Surgery, Northwestern university School of Medicine
Chicago, Illinois, United States
Stephanie S. Smith, MD, MS

Assistant Professor
Northwestern University Feinberg School of Medicine Department of Otolaryngology - Head and Neck Surgery
Chicago, IL, United States
Anthony M. Sheyn, MD, FACS

Division Chief, Pediatric Otolaryngology
LeBonheur Children's Hospital
Memphis, Tennessee, United States
JR

Jeffrey C. Rastatter, MD, MPH

Associate Professor
Lurie Children's Hospital / Northwestern University
Chicago, IL, United States

Senior Author(s)

JR

Jeffrey C. Rastatter, MD, MPH

Associate Professor
Lurie Children's Hospital / Northwestern University
Chicago, IL, United States

Disclosure(s):

David J. Fei-Zhang, BA: No relevant relationships to disclose.

Daniel C. Chelius, MD: No relevant relationships to disclose.

Anthony M. Sheyn, MD, FACS: No relevant relationships to disclose.

Introduction: Studies have compared the differences of predictors between HPV+/- head-neck cancers but are limited by number of patients with known HPV status, dated study samples, & analyses not accounting for all patient characteristics. Using modern, national patient datasets & multifactorial analyses accounting for varied sociodemographic factors & the Yost Index, an extensive, census-level socioeconomic status (SES) measure, we sought to comprehensively characterize the prognostic predictor differences across HPV+/- nasopharyngeal carcinomas

Methods: This retrospective cohort study between Sept-Dec 2022 analyzed 1222 adult, nasopharyngeal carcinomas with confirmed HPV status between 2010-2018 from SEER. Multivariate logistic regressions were conducted with age ( < 65 yrs), sex, race-ethnicity (black, Hispanic, Asian compared to white), census-level rurality-urbanicity, & census-level Yost-Index score (aggregates 7 SES-measures of education, income, housing, & employment) as covariates with disease/all-cause mortality, late-presenting stage, & delay-in-treatment after diagnosis (3mth+) as outcomes.

Results: 820 HPV- & 402 HPV+ nasopharyngeal carcinomas were assessed. For disease-specific mortality, HPV- uniquely showed positive predictors of younger age (OR 3.24, 95%CI 1.68-6.37) & Hispanic race (6.11, 1.14-114) & negative predictors of male sex (0.30, 0.11-0.73) while HPV+ did not. For 5-year all-cause mortality, HPV- showed positive predictors of low Yost-Index (1.71, 1.11-2.66) while HPV+ did not. For 3-year all-cause mortality, HPV- uniquely showed positive predictors of low Yost-Index (1.72, 1.17-2.53) while HPV+ uniquely showed positive predictors of male sex (1.81, 1.01-3.31). For late-presenting stage, HPV- showed positive predictors of younger age (1.48, 1.07-2.05) & black race (1.87, 1.14-3.09) while HPV+ did not. For delay-in-treatment, HPV- showed positive predictors of low Yost-Index (1.97, 1.16-3.42) while HPV+ did not

Conclusions: Modern, comprehensive analyses of HPV+/- nasopharyngeal carcinoma patients present vast differences in prognostic predictors.