Human papilloma virus and survival of oropharyngeal cancer patients treated with surgery and adjuvant radiotherapy
- 341 Downloads
Impact of p16 protein, a surrogate marker for human papilloma virus induced cancer, p53 and EGFR as well as clinical factors on survival in a patient cohort with oropharyngeal squamous cell carcinoma (OPSCC) treated by surgical resection and adjuvant radiotherapy (RT) ± concomitant chemotherapy (CT). This is a retrospective analysis of patient’s charts and tumor tissue. 57 patients were consecutively included and their tumor tissue assembled on a tissue microarray following immunohistochemical analysis. Survival times were estimated by means of Kaplan–Meier analysis. The importance of clinical and immunohistochemical factors for outcome was estimated by cox proportional hazard models. With 88 % 5-year overall survival, 91 % 5-year disease-specific survival and 91 % 5-year disease-free survival, respectively, we found excellent survival rates in this surgically treated patient cohort of mainly advanced OPSCC (93 % AJCC stage III or IV). The only factors positively influencing survival were p16 overexpression as well as p53 negativity and even more pronounced the combination of those biomarkers. Survival analysis of patients classified into three risk categories according to an algorithm based on p16, smoking, T- and N-category revealed a low, intermediate and high-risk group with significant survival differences between the low and the high-risk group. Patients with OPSCC can be successfully treated by surgery and adjuvant RT ± CT with a clear survival benefit of p16 positive, p53 negative patients. We recommend considering a combination of immunohistochemical (p16, p53) and clinical factors (smoking, T- and N-category) for risk stratification.
KeywordsOropharyngeal cancer Surgery Survival Human papillomavirus p16 p53
Conflict of interest
There are no financial disclosures or conflicts of interest.
- 2.Broglie MA, Soltermann A, Haile SR, Roosli C, Huber GF, Schmid S et al (2013) Quality of life of oropharyngeal cancer patients with respect to treatment strategy and p16-positivity. Laryngoscope 123(1):164–170Google Scholar
- 31.Dahlstrom KR, Calzada G, Hanby JD, Garden AS, Glisson BS, Li G et al (2013) An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center: a staging system in need of repair. Cancer 119(1):81–89Google Scholar
- 33.Park YM, Kim WS, Byeon HK, Lee SY, Kim SH (2013) Oncological and functional outcomes of transoral robotic surgery for oropharyngeal cancer. Br J Oral Maxillofac Surg 51(5):408–412Google Scholar
- 34.Al-Mamgani A, Van Rooij P, Tans L, Teguh DN, Levendag PC (2013) Toxicity and Outcome of Intensity-Modulated Radiotherapy versus 3-Dimensional Conformal Radiotherapy for Oropharyngeal Cancer: a Matched-Pair Analysis. Technol Cancer Res Treat 12(2):123–130Google Scholar
- 43.Ukpo OC, Flanagan JJ, Ma XJ, Luo Y, Thorstad WL, Lewis JS (2011) High-risk human papillomavirus E6/E7 mRNA detection by a novel in situ hybridization assay strongly correlates with p16 expression and patient outcomes in oropharyngeal squamous cell carcinoma. Am J Surg Pathol 35(9):1343–1350CrossRefPubMedGoogle Scholar
- 44.Holzinger D, Flechtenmacher C, Henfling N, Kaden I, Grabe N, Lahrmann B et al (2013) Identification of oropharyngeal squamous cell carcinomas with active HPV16 involvement by immunohistochemical analysis of the retinoblastoma protein pathway. Int J Cancer 133(6):1389–1399CrossRefPubMedGoogle Scholar