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Meta-analysis of survival in patients with HNSCC discriminates risk depending on combined HPV and p16 status

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Abstract

Data indicate a better prognosis for human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC). HPV and p16 detection are established markers for HPV-related HNSCC. Both are accepted as survival-independent predictors. Previous studies investigating the survival in HNSCC patients depending on HPV+/− and p16+/− status consistently found discordant results with p16−/HPV+ and p16+/HPV−. However, no meta-analysis regarding the survival according to combined HPV/p16 status has been performed yet. The objective of this study was to discriminate the impact of combined HPV+/− and p16+/− status on survival. Data sources were identification and review of publications assessing survival of the distinct subgroups with both p16 and HPV investigated in HNSCC until February, 2015. A meta-analysis was performed to classify survival and clinical outcomes. 18 out of 397 articles (4424 patients) were eligible for the meta-analysis. The percent proportion of the subgroups was 25 % for HPV+/p16+, 61.2 % for HPV−/p16−, 7.1 % for HPV−/p16+ and 6.8 % for HPV+/P16−. The meta-analysis showed a significantly improved 5-year overall survival (OS), 5-year disease-free survival and their corresponding hazard ratio for HPV+/p16+ HNSCC in comparison to HPV−/p16−, HPV+/p16− and HPV−/p16+. The 5-year OS of the HPV−/p16+ subgroup was intermediate while HPV+/p16− and HPV−/p16− HNSCC had the shortest survival. With current therapeutic strategies, survival of patients with HNSCC is better if associated with HPV+/p16+ or HPV−/p16+. Clinical trials are needed to confirm the distinct survival pattern and to investigate possible differences in survival for HPV+/p16− and HPV−/p16+ HNSCC. To further differentiate p16+ HNSCC, HPV testing may be advisable.

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  1. Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany

    Annekatrin Coordes, Xu Qian, Minoo Lenarz & Andreas E. Albers

  2. Institute of Medical Biometrics and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany

    Klaus Lenz

  3. Clinic for Gynecology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany

    Andreas M. Kaufmann

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Coordes, A., Lenz, K., Qian, X. et al. Meta-analysis of survival in patients with HNSCC discriminates risk depending on combined HPV and p16 status. Eur Arch Otorhinolaryngol 273, 2157–2169 (2016). https://doi.org/10.1007/s00405-015-3728-0

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