title: HPV-16 infection predicts treatment outcome in oropharyngeal squamous cell carcinoma.
abstract: OBJECTIVE
  To determine if patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) treated with chemoradiation have improved outcomes.
  
  
  METHODS
  A retrospective search was used to identify patients with OPSCC treated with concurrent chemoradiation. Pretreatment biopsy specimens were tested for HPV-16 infection and p16 expression.
  
  
  METHODS
  Forty-four patients with OPSCC treated with concurrent chemotherapy and intensity-modulated radiation therapy were identified. Eligibility criteria included a minimum two years of follow-up, or biopsy-proven recurrence. In situ hybridization was applied to archival tumor specimens, with HPV-16-positive status defined as positive staining of tumor cell nuclei. p16 expression was assessed by immunohistochemistry.
  
  
  RESULTS
  Twenty-seven tumors (61%) were positive for HPV-16 and 29 tumors (66%) expressed p16. HPV-16 infection was highly correlated with p16 expression (P < 10(-7)). Three-year disease-free and overall survival for all patients was 66 percent and 79 percent respectively. Patients with tumors infected with HPV-16 had improved overall (OS) and disease-free survival (DFS) after chemoradiation (OS: hazard ratio [HR] = 0.21, P = 0.01; DFS: HR = 0.30, P = 0.02).
  
  
  CONCLUSIONS
  Patients with OPSCC tumors that are infected with HPV-16 have improved survival after treatment with concurrent chemoradiation.
authors.affiliation: Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Nichols
authors.forename: William C
authors.initials: WC
authors.lastname: Faquin
authors.forename: William H
authors.initials: WH
authors.lastname: Westra
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Mroz
authors.forename: Shanaz
authors.initials: S
authors.lastname: Begum
authors.forename: John R
authors.initials: JR
authors.lastname: Clark
authors.forename: James W
authors.initials: JW
authors.lastname: Rocco
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000628:therapy / Q000821:virology*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000401:mortality* / Q000628:therapy / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications*; D011237:Predictive Value of Tests; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents