title: Human papillomavirus-related oropharyngeal cancer: HPV and p16 status in the recurrent versus parent tumor.
abstract: BACKGROUND
  Although typically associated with a favorable prognosis, a minority of human papillomavirus (HPV)-related (+) oropharyngeal cancers recur after chemoradiation. We postulated that a minor HPV-negative tumor subfraction may be responsible for recurrences of HPV+ oropharyngeal cancer.
  
  
  METHODS
  Paired untreated primary and recurrent tumor specimens were identified for 37 patients with oropharyngeal cancer who received definitive chemoradiotherapy at our institution. Concordance in HPV/p16 expression between primary and recurrent tumors was assessed.
  
  
  RESULTS
  Among 31 patients with HPV+/p16+ primary tumors, 30 (97%) retained evidence of both HPV and p16 expression at recurrence (27 HPV+/p16+; 3 HPV+/p16-partial). One (3%) initially HPV+/p16+ patient developed an HPV-negative/p16-negative lung squamous cell carcinoma (SCC), representing either a discordant oropharyngeal cancer metastasis or second primary tumor.
  
  
  CONCLUSIONS
  HPV-related oropharyngeal cancers retain HPV+/p16+ expression at recurrence. Our results fail to provide evidence that a minor HPV-negative tumor subfraction is responsible for biologically aggressive behavior of HPV+ oropharyngeal cancer that recurs after chemoradiation.
authors: Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
authors: Jeffrey
authors: J
authors: Vainshtein
authors: Jonathan B
authors: JB
authors: McHugh
authors: Matthew E
authors: ME
authors: Spector
authors: Heather M
authors: HM
authors: Walline
authors: Christine M
authors: CM
authors: Komarck
authors: Matthew H
authors: MH
authors: Stenmark
authors: Mark E
authors: ME
authors: Prince
authors: Francis P
authors: FP
authors: Worden
authors: Gregory T
authors: GT
authors: Wolf
authors: Carol R
authors: CR
authors: Bradford
authors: Douglas B
authors: DB
authors: Chepeha
authors: Thomas
authors: T
authors: Carey
authors: Avraham
authors: A
authors: Eisbruch
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy / Q000821:virology*; D059248:Chemoradiotherapy; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000821:virology*; D009959:Oropharyngeal Neoplasms / Q000473:pathology* / Q000628:therapy / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins
keywords: chemoradiation; expression profiling; human papillomavirus; oropharyngeal cancer; p16