title: Human papillomavirus-related squamous cell carcinoma of the oropharynx: a comparative study in whites and African Americans.
abstract: OBJECTIVE
  To evaluate the frequency of human papillomavirus-related oropharyngeal squamous cell carcinoma in African Americans and whites and to examine patient outcomes in these 2 groups.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  One tertiary care, university medical center.
  
  
  METHODS
  Information on patients with stage III/IV oropharyngeal squamous cell carcinoma diagnosed between 1998 and 2007, and with primary surgical samples available for review, were selected from a radiotherapy database. One patient was Native American and was excluded from analysis; data on 174 patients were analyzed.
  
  
  RESULTS
  One hundred forty-eight patients (85.1%) were white and 26 (14.9%) were African American. Human papillomavirus in situ hybridization-positive and p16-positive tumors were much more common in whites (63.5% and 83.1% of tumors, respectively) than in African Americans (11.5% and 34.6% of tumors, respectively) (P < .001). African Americans were also more likely to have received definitive (nonsurgical) rather than postoperative radiation therapy (P = .001) and had a higher frequency of T3/T4-stage tumors (P = .03) compared with whites. Disease-free survival was significantly shorter for African Americans (P = .02). In multivariate analysis, viral status (P = .006), T stage (P = .02), and treatment type (P = .002), but not race (P = .98), were significant factors contributing to disease-free survival.
  
  
  CONCLUSIONS
  In high-stage oropharyngeal squamous cell carcinoma, the proportion of human papillomavirus-related tumors is much higher in whites than in African Americans. African Americans also appear to develop higher T-stage tumors and are more likely to receive definitive therapy. The shorter disease-free survival observed in African Americans may be due to viral status, treatment type, and higher T stage, but does not appear to be due to race.
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8118, St Louis, MO 63110, USA. RChernock@path.wustl.edu
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Chernock
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.forename: Samir K
authors.initials: SK
authors.lastname: El-Mofty
authors.forename: Wade L
authors.initials: WL
authors.lastname: Thorstad
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology*; D018572:Disease-Free Survival; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D044465:White People; D001741:Black or African American