Sex-Specific Survival and Treatment Delay in Oropharyngeal Squamous Cell Carcinoma

Area of Science:

• Oncology
• Cancer Research
• Head and Neck Cancers

Background:

• Oropharyngeal squamous cell carcinoma (OPSCC) predominantly affects males, leaving female outcomes under-researched.
• Understanding sex-specific factors is crucial for improving prognostication in female OPSCC patients.

Purpose of the Study:

• To identify sex-specific factors influencing outcomes in oropharyngeal squamous cell carcinoma (OPSCC).
• To refine prognostication for female patients diagnosed with OPSCC.

Main Methods:

• Retrospective cohort analysis of 192,973 OPSCC cases from the National Cancer Database (2004-2019).
• Comparison of sociodemographic, clinical, and treatment characteristics between sexes.
• Multivariable regression models to analyze survival, treatment delays, and their impact on outcomes.

Main Results:

• Females (19%) presented with less advanced disease but had poorer survival, particularly in human papillomavirus (HPV)-negative OPSCC (HR=1.11).
• Females were more likely to experience delays in treatment initiation (OR=1.04) and adjuvant radiotherapy (OR=1.11).
• Treatment delays exceeding 60 days (HR=1.17) and adjuvant therapy delays (HR=1.24) were associated with worse survival in females.

Conclusions:

• Female OPSCC patients exhibit poorer survival than males, particularly in HPV-negative cases, despite earlier stage presentation.
• Treatment delays, especially in adjuvant radiotherapy, are more prevalent in females and significantly worsen survival.
• Systemic factors contributing to treatment delays may underlie the poorer prognosis observed in women with OPSCC.