title: Is p16-positive oropharyngeal squamous cell carcinoma associated with favorable prognosis? A systematic review and meta-analysis.
abstract: The purpose of this systematic review and meta-analysis was to compare the prognosis of patients with p16 expressing oropharyngeal squamous cell cancers to patients with p16 non-expressing cancers. Clinical outcomes that were evaluated included overall survival, local recurrence, disease-free survival, disease-specific survival, and event-free survival. The following electronic databases were searched: Cochrane Library, MEDLINE (via Pubmed), and Web of Science. Publications were restricted to English language. Studies were limited to controlled clinical trials on the survival rates of patients with oropharyngeal tumors that were p16 expressing, compared to patients with p16 non-expressing tumors, and at least one clinical endpoint reported by trial authors (hazard ratios). Specific ascertainment criteria were applied for inclusion and exclusion of eligible studies. Data was independently extracted in duplicate. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA checklist. Risk of bias was assessed for all included studies, and disagreements between review authors were discussed until an agreement was reached. Eighteen studies were included for final review and meta-analysis. The subgroup meta-analyses, which included survival and recurrence data, showed significantly favorable outcomes for patients with p16 expressing tumors. There is strong evidence to support that patients with p16 expressing oropharyngeal squamous cell cancers have favorable clinical outcomes and prognosis.
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States. Electronic address: sedghiza@usc.edu.
authors.forename: Parish P
authors.initials: PP
authors.lastname: Sedghizadeh
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
authors.forename: William D
authors.initials: WD
authors.lastname: Billington
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
authors.forename: Dain
authors.initials: D
authors.lastname: Paxton
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
authors.forename: Rabeh
authors.initials: R
authors.lastname: Ebeed
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Mahabady
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Clark
authors.affiliation: University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
authors.forename: Reyes
authors.initials: R
authors.lastname: Enciso
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000628:therapy* / Q000821:virology; D052162:Human papillomavirus 16; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000821:virology; D009959:Oropharyngeal Neoplasms / Q000628:therapy* / Q000821:virology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D011379:Prognosis; D016019:Survival Analysis
keywords: HPV; Head and neck cancer; Oral cancer; Oropharyngeal squamous cell carcinoma; Outcome; Prognosis; Survival; p16