title: Association between p53 status, human papillomavirus infection, and overall survival in advanced oral cancer after resection and combination systemic treatment.
abstract: Our previous study on 75 cases of advanced oral squamous cell carcinomas (SCC) treated by neoadjuvant chemotherapy, radical surgery, and radiotherapy showed that overexpression of p53 of more than 50% indicated a strong probability of genetic mutation, and tumours that are characterised by this p53 pattern respond poorly to treatment and have a poor prognosis (p= 0.0001). We have studied the same cohort of patients retrospectively to investigate the incidence of human papillomavirus-16 (HPV16) infection, the relation to the overexpression or mutation of the p53 gene, and the association with overall survival. There were 57 men and 18 women, mean age 67 (range 57-72) years. HPV16 infectivity was found in 66 patients (88%) - 49/57 men (86%) and 17/18 women (94%). There was no significant difference between the sexes (p=0.32). The cumulative survival of the entire group after a follow-up of 38 months was 26% (SE 6.4). The log rank test indicated that the combination of HPV-16 infectivity and p53mutation was significantly related to prognosis (p=0.000). On the other hand HPV16 infectivity alone was not significantly related to prognosis (p=0.78) The incidence of HPV-16 infection decreased with increasing immune p53 expression (p=0.005), whereas that of the HPV16+p53mutation combination increased with increasing immune p53 expression (p=0.000). The results show the importance of the investigation of HPV and p53 expression to define prognosis in oral SCC.
authors.affiliation: Head of Maxillofacial Surgery Operative Unit, President of Upgrading School of Maxillofacial Surgery, University of L'Aquila - Italy Department of Life, Health & Environmental Sciences. Electronic address: tommaso.cutilli@cc.univaq.it.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cutilli
authors.affiliation: Pathology President of Upgrading School of Anatomic Pathology, University of L'Aquila - Italy Department of Life, Health & Environmental Sciences. Electronic address: pleocata@cc.univaq.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Leocata
authors.affiliation: President of Clinical Pathology Postgraduate School, University of L'Aquila - Italy Department of Life, Health & Environmental Sciences. Electronic address: vincenza.dolo@univaq.it.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Dolo
authors.affiliation: Head of Epidemiology and Biostatistics Unit, University of L'Aquila - Italy Department of Life, Health & Environmental Sciences. Electronic address: emma.altobelli@cc.univaq.it.
authors.forename: Emma
authors.initials: E
authors.lastname: Altobelli
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms; D030361:Papillomavirus Infections; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: HPV Infection; Oral Cancer; Surgery; p53 Status