BACKGROUND To the authors' knowledge, the question of whether human papillomavirus (HPV) infection is associated with outcomes in patients with sinonasal squamous cell carcinoma (SNSCC) is not well studied at this time. In the current study, the authors investigated patterns of HPV testing and its association with survival in patients with SNSCC using the National Cancer Data Base. METHODS The authors selected all SNSCC cases diagnosed between 2010 and 2016. HPV testing practices, clinicodemographic factors, treatments, and survival were analyzed. Multivariable Cox regression and propensity score-matched survival analyses were performed. RESULTS A total of 6458 SNSCC cases were identified. Of these, only 1523 cases (23.6%) were tested for HPV and included in the current study. The median patient age was 64 years and the majority had advanced stage tumors (overall AJCC stage III-IV, 721 patients; 62.1%). HPV-positive SNSCC comprised 31.5% (447 of 1418 cases) of the final study cohort. Among 15 hospitals that routinely tested nonoropharyngeal SCCs for HPV, the percentage of HPV-positive SNSCCs was smaller (24.6%; P = .04). Patients with HPV-positive SNSCC were younger (aged 60 years vs 65 years; P < .001), with tumors that were more likely to be high grade (55.3% vs 41.7%; P < .001), and attributed to the nasal cavity (62.2% vs 44.0%; P < .001). HPV-positive SNSCC was associated with significantly improved overall survival in multivariable regression analysis (hazard ratio, 0.45; 95% CI, 0.28-0.72 [P = .001]) and propensity score-matched (hazard ratio, 0.61; 95% CI, 0.38-0.96 [P = .03]) analyses controlling for clinicodemographic and treatment factors. CONCLUSIONS Currently, only a minority of patients with SNSCC are tested for HPV. However, a sizable percentage of SNSCC cases may be HPV related; furthermore, HPV-positive SNSCC is associated with improved overall survival. Routine HPV testing may be warranted in patients with SNSCC.

中文翻译：

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人乳头瘤病毒与鼻窦鳞状细胞癌患者的生存。

背景技术据作者所知，目前尚不充分研究人乳头瘤病毒（HPV）感染是否与鼻窦鳞状细胞癌（SNSCC）患者的预后相关。在当前的研究中，作者使用美国国家癌症数据库调查了HPV检测的模式及其与SNSCC患者生存率的关系。方法作者选择了2010年至2016年期间诊断出的所有SNSCC病例。分析了HPV检测方法，临床人口统计学因素，治疗方法和生存期。进行了多变量Cox回归和倾向得分匹配的生存分析。结果共鉴定出6458例SNSCC病例。在这些研究中，只有1523例（23.6％）接受了HPV检测，并纳入了当前研究。患者的中位年龄为64岁，大多数患有晚期肿瘤（总体AJCC III-IV期，721名患者； 62.1％）。HPV阳性的SNSCC占最终研究队列的31.5％（1418例中的447例）。在常规检查非口咽SCCs HPV的15家医院中，HPV阳性SNSCCs的百分比较小（24.6％； P = .04）。HPV阳性SNSCC的患者年龄较小（年龄分别为60岁和65岁； P <.001），其肿瘤更可能是高级别的（55.3％vs 41.7％； P <.001），并且归因于鼻腔（62.2％vs 44.0％; P <.001）。HPV阳性SNSCC与多变量回归分析（危险比，0.45； 95％CI，0.28-0.72 [P = .001]）和倾向评分匹配（危险比，0.61； 95％CI， 0.38-0.96 [P =。03]）分析了临床人口统计学和治疗因素的控制。结论当前，只有少数SNSCC患者接受了HPV检测。但是，相当大比例的SNSCC病例可能与HPV相关；此外，HPV阳性的SNSCC与改善的总生存期有关。SNSCC患者可能需要常规HPV检测。