title: Human papillomavirus-related cell cycle markers can predict survival outcomes following a transoral lateral oropharyngectomy for tonsillar squamous cell carcinoma.
abstract: OBJECTIVE
  To identify the prognostic implications of human papillomavirus (HPV)-related cell cycle marker profiles in patients who have received a transoral lateral oropharyngectomy (TLO) as a primary treatment for tonsillar squamous cell carcinoma (TSCC).
  
  
  METHODS
  Immunohistochemical profiles of HPV-related cell cycle markers, including p16, pRb, cyclin D1, p53, and the HPV DNA status of 42 consecutive TSCC patients who underwent TLO-based treatments were analyzed. The prognostic value of each marker was evaluated.
  
  
  RESULTS
  Univariate analysis indicated that high p16, low pRb, and low p53 expression levels are significantly associated with a good disease-free and overall survival outcome. Clinicopathological parameters and the HPV DNA status did not show prognostic significance. When adjusted for age, overall stage and treatment strategy, a high p16 and low pRb level remained an effective prognostic marker for good survival outcomes. A high p16/low pRb combination showed superior survival prediction ability over high p16 or low pRb alone.
  
  
  CONCLUSIONS
  HPV-related cell cycle markers may also be good indicators for predicting survival after TLO for TSCC. The de-escalation TLO surgery approach would be more effective if performed under the stringent guidance of these markers.
authors.affiliation: Specific Organs Cancer Branch, Department of Otolaryngology, Center for Thyroid Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Ryu
authors.forename: Junsun
authors.initials: J
authors.lastname: Ryu
authors.forename: Kwan Ho
authors.initials: KH
authors.lastname: Cho
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Moon
authors.forename: Tak
authors.initials: T
authors.lastname: Yun
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Moon Kyung
authors.initials: MK
authors.lastname: Choi
authors.forename: Weon Seo
authors.initials: WS
authors.lastname: Park
authors.forename: Yuh-S
authors.initials: YS
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000401:mortality / Q000601:surgery* / Q000821:virology; D002453:Cell Cycle; D019938:Cyclin D1 / Q000032:analysis; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D009960:Oropharynx / Q000601:surgery*; D027383:Papillomaviridae / Q000302:isolation & purification*; D016160:Retinoblastoma Protein / Q000032:analysis; D014067:Tonsillar Neoplasms / Q000737:chemistry / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: C530104:CCND1 protein, human; C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral; D009363:Neoplasm Proteins; D016160:Retinoblastoma Protein; D016159:Tumor Suppressor Protein p53; D019938:Cyclin D1
keywords: human papillomavirus; p16; pRb; squamous cell carcinoma; survival; tonsil