{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:45:22Z","timestamp":1791949522742,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the prognostic relevance of human papillomavirus (HPV) in nasopharyngeal carcinoma (NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Cancer Data Base (NCDB) was used to query patients with NPC and available HPV testing data between 2010 and 2017. Logistic regression was performed to predict factors associated with HPV testing and HPV positivity. Overall survival (OS) was evaluated using Kaplan Meier analysis between HPV\u2010positive versus HPV\u2010negative cohorts. Univariate and multivariate analyses using Cox proportional hazards modeling were performed to assess for factors associated with OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among our cohort of 5081 patients, 3177 (62.5%) underwent HPV testing. Kaplan Meier analysis revealed improved OS among HPV\u2010positive patients with keratinizing subtype of NPC (log rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No differences in OS were observed in patients with other histologic subtypes of NPC. On multivariate analysis of the keratinizing SCC cohort, HPV positivity was associated better OS after controlling for sex, age, race, insurance status, facility volume, facility type, zip code level education, Charlson comorbidity score, staging, and treatment (HR 0.81, 95% CI: 0.70\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HPV status was independently associated with improved OS among patients with keratinizing subtype of NPC. Incorporation of HPV testing may be warranted in the workup of NPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70999","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:54:51Z","timestamp":1791946491000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>HPV<\/scp>\n                    \u2010Positive Keratinizing Nasopharyngeal Carcinoma Is Associated With Better Survival: A\n                    <scp>NCDB<\/scp>\n                    Study"],"prefix":"10.1002","author":[{"given":"Hannah","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Tufts Medical Center  Boston Massachusetts 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