Females Have Worse Overall and Disease-Specific Survival in Human Papillomavirus–Negative Oropharyngeal Squamous Cell Carcinoma

Hunter, William P.; Harris, Jack A.; Lee, Cameron C.; Cheng, Allen

doi:10.1016/j.joms.2022.03.017

Cited by 2 publications

(5 citation statements)

References 24 publications

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Section: Discussionmentioning

confidence: 98%

“…Based on a national database, Hunter et al. reported worse survival in females diagnosed with HPV-negative OPSCC, despite lower grade and stage, in a sample size of 2,565 patients ( 7 ). OS was found to be 40.7% for females and 54.2% for males at three years.…”

Section: Discussionmentioning

confidence: 99%

“…Sex discrepancies in survival of oral cancer patients remain an issue for discussion. Previous studies identified sex as an independent factor for the prognosis in OPSCC, with controversial reports, however (7,17). Fakhry et al reported greater survival in females with HPV-positive OPSCC ( 17) and laryngeal squamous cell carcinoma (3).…”

Section: Discussionmentioning

confidence: 99%

“…Fakhry et al reported greater survival in females with HPV-positive OPSCC ( 17) and laryngeal squamous cell carcinoma (3). Based on a national database, Hunter et al reported worse survival in females diagnosed with HPV-negative OPSCC, despite lower grade and stage, in a sample size of 2,565 patients (7). OS was found to be 40.7% for females and 54.2% for males at three years.…”

Section: Discussionmentioning

confidence: 99%

“…In the field of head and neck cancers, HPV is a well-studied driver for the development of OPSCC ( 5 ) and HPV-status is intimately linked to sexual behavior ( 6 ). In HPV-negative OPSCC, Hunter et al reported worse outcomes in female patients with regard to disease-specific survival (DSS) and OS, as compared to male patients ( 7 ). A recent study demonstrated worse OS and DFS in females with early-stage tongue squamous cell carcinoma ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Worse prognosis in females with new onset of depression after oral cancer diagnosis: a retrospective case-control study

Hofmann,

Doll,

Rogge

et al. 2023

Front. Oncol.

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BackgroundSex-related discrepancies in the prognosis of oral cancer patients have not been clarified. This study aimed to assess survival outcomes and potential prognostic factors in female and male patients with oral cancer.MethodsA retrospective search of the TriNetX network (TriNetX, Cambridge, Massachusetts, USA) was conducted to identify patients diagnosed with oral cancer (International Classification of Diseases (ICD)-10 codes C02–C06), within the past 20 years from the access date April 21, 2023. Patients were categorized according to sex (female vs. male). Following matching for age and risk factors such as nicotine dependence and alcohol abuse, Kaplan-Meier analysis was performed and risk, odds, and hazard ratios were calculated. Outcome variables were five-year disease-free survival (DFS) and overall survival (OS). Additionally, the female and male patient cohort were compared with regard to the novel diagnosis of depression (depressive episode, major depressive disorder, dysthymic disorder) after the tumor diagnosis.ResultsA total of 77,348 patients were assessed. After propensity score matching, 26,578 male and 26,578 female patients were included in each group (mean age 63 years). DFS (71.92% in females vs. 68.29% in males; hazard ratio (HR) 0.870; p < 0.001) and OS (77.08% in females vs. 71.74% in males; HR 0.793; p < 0.001) were significantly higher in the female cohort. However, in patients diagnosed with depression after the initial cancer diagnosis (N = 4,824), survival was worse in female patients compared to male patients (82.48% in females vs. 86.10% in males; HR 1.341; p < 0.001).ConclusionThis retrospective case-control study showed that females with oral cancer had a better DFS and OS than males. However, survival in females with a newly diagnosed depression after the oral cancer diagnosis was worse compared to those of male oral cancer patients. Depression may be a relevant prognostic factor that contributes to sex disparities in oral cancer patients.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Worse prognosis in females with new onset of depression after oral cancer diagnosis: a retrospective case-control study

Hofmann,

Doll,

Rogge

et al. 2023

Front. Oncol.

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Sex‐Specific Survival and Treatment Delay in Oropharyngeal Squamous Cell Carcinoma

Kalavacherla,

Poulhazan,

Funk

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveAs the majority of oropharyngeal squamous cell carcinoma (OPSCC) is diagnosed in males, outcomes among females are not well‐characterized. We identify sex‐specific factors in OPSCC to refine female prognostication.Study DesignRetrospective cohort.SettingNational Cancer Database (NCDB).MethodsOPSCC cases from the 2004 to 2019 NCDB were identified. Sociodemographic, clinical, and treatment characteristics (including timing between diagnosis and treatment administration) were compared between sexes. Multivariable Cox proportional hazard regression models were constructed to characterize survival in overall and female‐only cohorts. Similar multivariable binomial logistic regression and survival models were constructed to assess odds of treatment delays and their effects on survival, respectively.ResultsA total of 192,973 OPSCC patients were identified; 36,695 (19%) were female. Females had more human papillomavirus (HPV) negative, lower clinical T and N stage, and higher comorbidity disease. Females experienced lower survival in HPV negative (hazard ratio, HR = 1.11, P < .001) but not HPV‐positive disease. Females were more likely to have any treatment initiated over the median of 28 days (odds ratio, OR = 1.04, P = .014) or delays in adjuvant radiotherapy initiation over 6 weeks (OR = 1.11, P = .032). Treatment delay over 60 days (HR = 1.17, P = .016) and delay in adjuvant therapy initiation (HR = 1.24, P = .02) were associated with worse survival among females.ConclusionIn one of the largest analyses of OPSCC, females had poorer survival than males, specifically in HPV‐negative disease, despite presentation with less advanced disease. Notably, delays in any treatment initiation and adjuvant radiotherapy initiation were more likely in HPV‐negative women and associated with worse survival, highlighting potential systemic weaknesses contributing to poor prognosis among females.

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Females Have Worse Overall and Disease-Specific Survival in Human Papillomavirus–Negative Oropharyngeal Squamous Cell Carcinoma

Cited by 2 publications

References 24 publications

Worse prognosis in females with new onset of depression after oral cancer diagnosis: a retrospective case-control study

Worse prognosis in females with new onset of depression after oral cancer diagnosis: a retrospective case-control study

Sex‐Specific Survival and Treatment Delay in Oropharyngeal Squamous Cell Carcinoma

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