title: Is the improved prognosis of p16 positive oropharyngeal squamous cell carcinoma dependent of the treatment modality?
abstract: The incidence of human papilloma virus (HPV) induced oropharyngeal squamous cell carcinoma (OPSCC) increases in the western countries. These OPSCC show distinct molecular characteristics and are characterized by an overexpression of p16, considered a surrogate marker for HPV infection. When compared to patients with p16 negative OPSCC, patients with HPV induced p16 positive OPSCC show a significantly better prognosis, which is reported to be caused by increased radiosensitivity. The objective of the present study was to analyze the impact of p16 expression status on the prognosis of OPSCC treated by either radiotherapy (RT) or primary surgery. Results are based upon a tissue microarray (TMA) of 365 head neck squamous cell carcinomas (HNSCC) including 85 OPSCC with clinico-pathological and follow-up data. p16 positivity correlated significantly with oropharyngeal tumor localization (p < 0.001). Patients with p16 positive OPSCC exhibited a significantly better overall survival than those with p16 negative tumors (p = 0.007). In a multivariate analysis, survival benefit of patients with p16 positive OPSCC was independent of clinico-pathological parameters such as cT and cN classification and treatment modality. The improved prognosis of p16 positive OPSCC is found after RT as well as after surgery.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University Hospital, Basel, Switzerland. cfischer@uhbs.ch
authors.forename: Claude A
authors.initials: CA
authors.lastname: Fischer
authors.forename: Inti
authors.initials: I
authors.lastname: Zlobec
authors.forename: Edith
authors.initials: E
authors.lastname: Green
authors.forename: Simone
authors.initials: S
authors.lastname: Probst
authors.forename: Claudio
authors.initials: C
authors.lastname: Storck
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lugli
authors.forename: Luigi
authors.initials: L
authors.lastname: Tornillo
authors.forename: Markus
authors.initials: M
authors.lastname: Wolfensberger
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Terracciano
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy / Q000821:virology*; D003131:Combined Modality Therapy; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications*; D011379:Prognosis; D011878:Radiotherapy; D046888:Tissue Array Analysis
chemical_list: D000970:Antineoplastic Agents; D019941:Cyclin-Dependent Kinase Inhibitor p16