title: Transoral robotic surgery and adjuvant therapy for oropharyngeal carcinomas and the influence of p16 INK4a on treatment outcomes.
abstract: OBJECTIVE
  To determine the prognostic influence of p16(INK4a) immunohistochemistry on the survival of resectable oropharyngeal carcinomas (OPSCC).
  
  
  METHODS
  Retrospective pathologic evaluation of a prospective single-arm cohort study at a tertiary referral center.
  
  
  METHODS
  There were 48 patients with resectable OPSCC who consented for transoral robotic surgery (TORS) and banked tissue specimen for assessment. TORS was with or without adjuvant radiation or chemoradiation. Main outcome measures were p16(INK4a) status, human papillomavirus status, local-regional disease control, and overall, disease-specific, and disease-free survival.
  
  
  RESULTS
  p16(INK4a) and HPV positivity were identified in 73% and 74% of patients respectively. With a median follow-up of 38.8 months (2.5-63.3 months), only one local-regional relapse has occurred in both the p16(INK4a)-positive and p16(INK4a) -negative cohorts. No disease-specific, disease-free, and overall survival differences were observed between p16(INK4a) -positive and p16(INK4a)-negative patients (P = .446, P = .277, P = .643, respectively).
  
  
  CONCLUSIONS
  p16(INK4a) was not prognostic in resectable OPSCC when treated with an initial TORS approach.
authors.affiliation: Department of Radiation Oncology, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Quon
authors.forename: Marc A
authors.initials: MA
authors.lastname: Cohen
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Montone
authors.forename: Amy F
authors.initials: AF
authors.lastname: Ziober
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Wang
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Weinstein
authors.forename: Bert W
authors.initials: BW
authors.lastname: O'Malley
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000821:virology; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D018572:Disease-Free Survival; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D009959:Oropharyngeal Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000821:virology; D030361:Papillomavirus Infections / Q000378:metabolism; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16