Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma

Suat Kılıç, Sarah S. Kılıç, Emilie S. Kim, Soly Baredes, Omar Mahmoud, Stacey T. Gray, Jean Anderson Eloy

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background: The role of human papillomavirus (HPV) in sinonasal squamous cell carcinoma (SNSCC) is not well understood. Methods: The National Cancer Database was queried for cases of SNSCC with known HPV status. Demographics, socioeconomic variables, TNM stage, histology, grade, treatment modalities, and overall survival (OS) through 5 years were compared between HPV-positive and HPV-negative tumors. Cox proportional hazard regression analyses were performed. Results: Seven hundred seventy (770) cases were identified; 526 were HPV-negative (68.3%) and 244 (31.7%) were HPV-positive. Patients with HPV-positive tumors were younger (58.0 vs 63.7 years, p < 0.0001). Nasal cavity (49.4%) tumors were more likely to be HPV-positive (p < 0.05) than maxillary (18.8%), ethmoid (18.8%), and frontal (18.2%) sinus tumors. Large cell nonkeratinizing (42.4%), papillary (42.1%), and basaloid (56.5%) tumors were more likely than keratinizing (25.2%) tumors to be HPV-positive (p < 0.05). Well-differentiated (grade I) tumors (9.0%) were less likely than higher grade tumors to be HPV-positive (p < 0.05). Gender, race, facility type, insurance type, median income, education level, Charlson-Deyo comorbidity score, overall stage, T stage, N stage, M stage, tumor size, treatment modality, surgical approach, and surgical margins did not vary by HPV status (p ≥ 0.05). HPV-positive tumors had higher OS than HPV-negative tumors (p < 0.0001). At 5 years, OS was 68.1% and 51.5% for HPV-positive and HPV-negative tumors, respectively. On multivariate analyses, HPV positivity remained a favorable prognostic factor (hazard ratio, 0.49; 95% confidence interval, 0.34-0.70). Conclusion: HPV positivity is more common in nasal cavity SCC and nonkeratinizing SNSCC. It is also a favorable prognostic factor in SNSCC. Future studies on SNSCC should take HPV positivity into consideration.

Original languageEnglish (US)
Pages (from-to)980-989
Number of pages10
JournalInternational Forum of Allergy and Rhinology
Issue number10
StatePublished - Oct 2017

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Otorhinolaryngology


  • HPV
  • NCDB
  • National Cancer Database
  • human papillomavirus
  • sinonasal cancer
  • sinus
  • squamous cell carcinoma
  • survival


Dive into the research topics of 'Significance of human papillomavirus positivity in sinonasal squamous cell carcinoma'. Together they form a unique fingerprint.

Cite this