2026 Poster Presentations
P297: INTERPLAY OF TUMOR GRADE AND HPV STATUS ON SURVIVAL OUTCOMES IN SINONASAL SQUAMOUS CELL CARCINOMA
Jack Birkenbeuel; Neil Thakkar; Mengda Yu; Eric Nisenbaum, MD; Ricardo Carrau, MD; Kyle Vankoevering, MD; The Ohio State University
Background: Sinonasal squamous cell carcinoma (SCC) is a rare and understudied malignancy of the head and neck. Tumor grade and human papillomavirus (HPV) status are known prognostic factors. HPV has typically portended an improved survival, while poorly differentiated tumors have shown worse survival in some cohorts. However, their combined effect on survival outcomes has not been previously evaluated.
Objective: To investigate the combined impact of tumor grade and HPV status on overall survival in patients with sinonasal SCC using a large national database.
Study Design: Retrospective cohort study.
Methods: The National Cancer Database (NCDB) was queried for patients diagnosed with sinonasal SCC between 2004 and 2017. Patients with available data on tumor grade and HPV status were included. Clinicopathological features and treatment modalities were recorded. Patients were stratified into four groups based on tumor differentiation and HPV status:
Group 1: Well/moderately differentiated, HPV-negative
Group 2: Well/moderately differentiated, HPV-positive
Group 3: Poorly differentiated, HPV-negative
Group 4: Poorly differentiated, HPV-positive
Survival outcomes were assessed using Kaplan-Meier analysis and multivariable Cox proportional hazards models.
Results: A total of 3,393 patients met inclusion criteria (mean age: 63.9 ± 13.3 years). HPV positivity was observed in 177 patients (5.2%), and 1,302 tumors (38.4%) were poorly differentiated. Multivariable analysis showed a significant interaction between tumor grade and HPV status on overall survival (Type III p = 0.015). Compared to Group 1, patients in Group 3 had significantly worse survival (HR = 1.13, 95% CI: 1.03–1.24, p = 0.014). No significant survival differences were found between Groups 2 and 4 (HR = 0.69, 95% CI: 0.43–1.10, p = 0.118), or between Groups 3 and 4 (HR = 1.09, 95% CI: 0.80–1.48, p = 0.576).
Conclusions: Sinonasal SCC is a complex, multifaceted disease with a myriad of factors impacting the disease course. The combined influence of HPV status and tumor grade significantly impacts overall survival in sinonasal SCC, indicating these variables may interact to affect prognosis. These findings highlight that continued research into the disease biology and a thoughtful approach is warranted.