Facility Type Predicts Treatment Regimen for Human Papillomavirus Positive Oropharyngeal Squamous Cell Carcinoma

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ABSTRACT Objectives Treatment landscapes are changing for HPV+ oropharyngeal cancer (OPC) without compromising oncologic outcomes. We aim to analyze treatment trends of HPV+ OPC at academic (ACs) and nonacademic centers (NACs). Methods The National Cancer Database was queried, and multinomial logistic regression was used to predict treatment trends. Results In total, 30,243 HPV+ OPC patients were included; 15,155 (50.1%) at NAC and 15,088 (49.9%) at AC. More patients underwent surgery at AC (p < 0.05), were less likely to receive primary RT in ES and AS (OR = 0.57; OR = 0.80), and less likely to receive definitive CRT compared to surgery (OR = 0.62; OR = 0.76). ES patients who received surgery versus RT or CRT alone had higher 5‐year overall survival (p = 0.04). Conclusions ACs are more likely to utilize surgery as the primary treatment modality for HPV+ OPC rather than definitive RT or CRT. This points to a lack of standardized treatment regimens dependent on facility resources.

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