The impact of the relation of human papillomavirus (HPV) and smoking status of oropharyngeal squamous cell carcinoma (OPSCC) on overall survival (OS) was investigated in a retrospective population-based study in Thuringia, Germany. A total of 498 patients with OPSCC (76.9% men; mean age 62.5 years) from 2018 to 2020 were included. OPSCC cases were 37.3% HPV-positive (+) (31.2% smokers; mean incidence: 2.91/100,000 population) and 57.8% HPV-negative (63.5% smokers; mean incidence: 4.50/100,000 population). Median follow-up was 20 months. HPV+ patients had significantly better OS than HPV-negative (−) patients (HPV+: 2-year OS: 90.9%; HPV−: 2-year OS: 73.6%;p< 0.001). In multivariable analysis, HPV− patients (hazard ratio (HR) = 4.5; 95% confidence interval (CI): 2.4–8.6), patients with higher N classification (N2: HR = 3.3; 95% CI: 1.71–6.20; N3: HR = 3.6; 95% CI: 1.75–7.31) and with a higher cancer staging (III: HR = 5.7; 95% CI: 1.8–17.6; IV: HR = 19.3; 95% CI: 6.3–57.3) had an increased hazard of death. HPV− smokers formed the majority in Thuringia. Nicotine and alcohol habits had no impact on OS. Optimizing OPSCC therapeutic strategies due to the dominance of HPV− is more important than discussing de-escalation strategies for HPV+ patients.
本研究在德国图林根州开展了一项基于人群的回顾性研究，旨在探讨人乳头瘤病毒（HPV）感染状态与吸烟状况对口咽鳞状细胞癌（OPSCC）患者总生存期（OS）的影响。研究纳入了2018年至2020年间498例OPSCC患者（男性占76.9%；平均年龄62.5岁）。其中HPV阳性（+）病例占37.3%（吸烟者占31.2%；平均发病率：2.91/10万人口），HPV阴性病例占57.8%（吸烟者占63.5%；平均发病率：4.50/10万人口）。中位随访时间为20个月。HPV阳性患者的OS显著优于HPV阴性患者（HPV+：2年OS为90.9%；HPV−：2年OS为73.6%；p < 0.001）。多变量分析显示，HPV阴性患者（风险比（HR）= 4.5；95%置信区间（CI）：2.4–8.6）、较高N分级的患者（N2：HR = 3.3；95% CI：1.71–6.20；N3：HR = 3.6；95% CI：1.75–7.31）以及较高癌症分期的患者（III期：HR = 5.7；95% CI：1.8–17.6；IV期：HR = 19.3；95% CI：6.3–57.3）死亡风险显著增加。在图林根州，HPV阴性吸烟者构成了患者主体。尼古丁和酒精摄入习惯对OS无显著影响。鉴于HPV阴性患者占主导地位，优化OPSCC治疗策略比讨论HPV阳性患者的降级治疗策略更为重要。
肿瘤(癌症)患者之家