{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:05:01Z","timestamp":1791990301793,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prognostication of Epstein\u2013Barr virus (EBV) and human papillomavirus (HPV) status in nasopharyngeal cancer (NPC) is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed NPC from 2000 to 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010eight patients were included: 43 EBV\n                      <jats:sup>+<\/jats:sup>\n                      , 12 HPV\n                      <jats:sup>+<\/jats:sup>\n                      , 23 EBV\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/HPV\n                      <jats:sup>\u2212<\/jats:sup>\n                      , and 0 EBV\n                      <jats:sup>+<\/jats:sup>\n                      \/HPV\n                      <jats:sup>+<\/jats:sup>\n                      . All p16\n                      <jats:sup>+<\/jats:sup>\n                      tumors were also positive for HPV\u2010CISH. Baseline characteristics were not different between groups except age, N\u2010classification, and Karnofsky Performance Scale (KPS) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). For EBV\n                      <jats:sup>+<\/jats:sup>\n                      , HPV\n                      <jats:sup>+<\/jats:sup>\n                      , and EBV\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/HPV\n                      <jats:sup>\u2212<\/jats:sup>\n                      respectively, 3\u2010year overall survival (OS) was 89.9%, 69.8%, and 52.5% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.006). EBV\n                      <jats:sup>\u2212<\/jats:sup>\n                      \/HPV\n                      <jats:sup>\u2212<\/jats:sup>\n                      status was significantly associated with worse OS but not freedom from progression (FFP) on univariate analysis, and did not remain a significant predictor of OS after adjusting for KPS, age, and group stage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      EBV\n                      <jats:sup>+<\/jats:sup>\n                      NPC tumors were seen in younger, healthier patients than HPV\n                      <jats:sup>+<\/jats:sup>\n                      and EBV\n                      <jats:sup>\u2212<\/jats:sup>\n                      tumors, and there were no cases of coinfection. The association of viral status with OS was insignificant after adjusting for KPS and age.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.26976","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T06:35:17Z","timestamp":1642487717000},"page":"851-861","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Nasopharyngeal cancer: Incidence and prognosis of human papillomavirus and Epstein\u2013Barr virus association at a single North American institution"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0809-9143","authenticated-orcid":false,"given":"Shannon S.","family":"Wu","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Chen","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akeesha A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pathology Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Pathology Pathology &amp; Laboratory Medicine Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaim","family":"Domb","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandana A.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shauna R.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil M.","family":"Woody","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Lamarre","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon L.","family":"Prendes","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Scharpf","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Schwartzman","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; 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