Purpose: To evaluate the impact of race (African-American [AA] vs. Caucasians [C]) on the survival outcome in patients with oropharyngeal squamous-cell carcinoma (SCC) known HPV/p16 status. Methods: Between 2008 and 2018, eighty patients with known HPV/p16 status were diagnosed with oropharyngeal SCC in our academic state institution. Chi-square test, Kaplan-Meier method, and Cox regression models were used to assess for racial influence; p-values less than 0.05 were considered statistically significant. The SPSS v.24.0 was used for all statistical analyses. Results: The median follow-up duration was 34 months (range 0 to 154 months). Our patient cohort included 48.8% AA and 51.2% C (median age, 61 y; range 45-86 y) patients.
Patient risk groups were stratified based on HPV/p16 status, pack-years [py] of tobacco smoking, and tumor stage into low (p16+, ≤10 py), intermediate (p16+, >10 py/p16-, <10 py), and high risk (p16-, >10 py/ any T4), accounting for 2.6%, 25.6% and 71.8% of AA vs. 24.4%, 26.8% and 48.8% of C patients, respectively (p=0.013). The C patients had better 5-year overall survival [OS] rates (88.9%, 62.2% and 37.5% vs. na, 48.0% and 25.6% compared to AA patients stratified by risk (p=0.009). The OS of low risk AA patients was not assessable because of a low number (1) of patients in that group. In the bivariate Cox regression analysis, the covariates stratified by race, type of insurance, BMI level, HPV/p16 status, risk groups, and 8th AJCC staging were statistically significant with p-value less than 0.05. In the multivariate analysis, the covariates of insurance-private was associated with 87% reduction (hazard ratio, 0.13; 95% CI, 0.03-0.61; p=0.010), insurance-Medicare was associated with 71% reduction (hazard ratio, 0.29; 95% CI, 0.11-0.74; p=0.010), and AJCC TNM stages III, IV and IVB (98%, 97% and 93%) with reduction in the risk of death (hazard ratio, 0.02; 95% CI, 0.00-0.38; p=0.009), (hazard ratio, 0.03; 95 CI, 0.00-0.55; p=0.017), (hazard ratio, 0.07; 95% CI, 0.00-0.92), respectively. In terms of local control [LC], the C patients also had better 3-year rates 66.4%, vs. 32.8% compared to AA patients (p=0.049). Conclusion: In our patient population, race appears to be an independent prognostic factor for OS and LC in oropharyngeal SCC patients with known HPV/p16 status.
Citation Format: Mary R. Nittala, Eswar K. Mundra, Maurice L. King, Ashley Albert, Williams C. Woods, Maria L. Smith, Robert D. Hamilton, Lana Jackson, Gina Jefferson, Satyaseelan Packianathan, Varsha Manucha, Srinivasan Vijayakumar. Impact of race on outcomes in oropharyngeal squamous-cell carcinoma patients with known HPV/p16 status [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-104.