title: Prognostic significance of tumour progression and human papillomavirus in advanced tonsillar cancer classified as stage IVa.
abstract: OBJECTIVE
  To identify clinical factors that can explain the differences in treatment outcome, and examine the value of human papillomavirus infection as a prognostic biomarker in stage IVa tonsillar carcinomas.
  
  
  METHODS
  Fifty-nine patients with tonsillar carcinoma classified as stage IVa were retrospectively analysed for survival outcomes according to various clinical factors. Human papillomavirus infection was evaluated using a human papillomavirus DNA chip test and immunohistochemical staining for p16 and p53.
  
  
  RESULTS
  Lower disease-free survival rates were associated with increasing local invasiveness and nodal status. Although human papillomavirus positivity and p16 expression was more common in locally advanced tonsillar carcinomas with advanced nodal status, the overall survival rate was better for patients with human papillomavirus positive, p16-positive tumours.
  
  
  CONCLUSIONS
  The disease-free survival rate may differ according to local tumour invasiveness and nodal status, even for stage IVa tonsillar cancers. Human papillomavirus infection may be a useful biomarker for predicting treatment outcomes for stage VIa tumours.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: E
authors.initials: E
authors.lastname: Park
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: K-Y
authors.initials: KY
authors.lastname: Jung
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Kwon
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: J-S
authors.initials: JS
authors.lastname: Woo
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: J-G
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: M W
authors.initials: MW
authors.lastname: Park
authors.affiliation: Department of Pathology,Korea University College of Medicine,Seoul,Korea.
authors.forename: I S
authors.initials: IS
authors.lastname: Kim
authors.affiliation: Department of Pathology,Korea University College of Medicine,Seoul,Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Korea University College of Medicine,Seoul,Korea.
authors.forename: S-K
authors.initials: SK
authors.lastname: Baek
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000737:chemistry / Q000401:mortality* / Q000473:pathology* / Q000821:virology; D019941:Cyclin-Dependent Kinase Inhibitor p16; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D020411:Oligonucleotide Array Sequence Analysis; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000401:mortality* / Q000473:pathology*; D012189:Retrospective Studies; D012907:Smoking; D014067:Tonsillar Neoplasms / Q000737:chemistry / Q000401:mortality* / Q000473:pathology* / Q000821:virology; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins; D016159:Tumor Suppressor Protein p53
keywords: p53 Tumor Suppressor Protein