Exploring the use of oropharyngeal cancer histology to account for hpv status in population-based studies

Aim: To assess whether poorly differentiated tumors and non-keratinizing tumors have similar demographic and clinical characteristics as human papilloma virus (HPV)-positive tumors in patients with oropharyngeal cancer. Patients and Methods: The study cohort included patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012 identified in the Surveillance, Epidemiology, and End Results 18 Database. Results: Poorly differentiated tumors were associated with early T stage (odds ratio (OR)=1.23), nodal metastasis (OR=1.66) and tonsil fossa origin (OR=1.22). Non-keratinizing tumors were associated with early T stage (OR=1.23), nodal metastasis (OR=1.66) and tonsil fossa origin (OR=1.22). Poorly differentiated tumors were associated with improved overall survival (OS) (hazard ratio (HR)=0.78, p<0.001). Non-keratinizing tumors were associated with improved OS (HR=0.71, p<0.001). Conclusion: Histological grade and keratinization may be useful surrogates to adjust for the effects of HPV status in oropharyngeal cancer studies utilizing population-based cancer databases.