Human papillomavirus and survival of patients per histological subsite of tonsillar squamous cell carcinoma

Abstract

Current data advocate that oropharyngeal squamous cell carcinoma (OPSCC) should be divided into subsites when evaluating the presence of human papillomavirus (HPV) and prognosis. More specifically, tonsillar squamous cell carcinoma (TSCC) and base of tongue squamous cell carcinoma (BOTSCC) have much higher HPV prevalence compared to other OPSCC. Moreover, patients with HPV positive (HPV+) TSCC and BOTSCC have a better prognosis as compared to patients with HPV negative (HPV−) corresponding tumors, while the prognostic role of HPV in other OPSCC is unclear. Furthermore, in a recent report from Denmark, TSCC was further subclassified into specified TSCC (STSCC) and nonspecified TSCC (NSTSCC), with HPV significantly more prevalent in STSCC. In this study, the histopathological influence of HPV prevalence and survival in TSCC was analyzed in a TSCC cohort with known HPV status, of patients diagnosed 1970–2002 in Stockholm. In total, 139 TSCC biopsies with both tumor and adjacent normal tissue were separated into STSCC and NSTSCC. HPV was significantly more commonly found in STSCC than in NSTSCC. Patients with HPV+ STSCC had a better disease‐specific and overall survival as compared to patients with HPV+ NSTSCC, but no survival differences were observed in patients with HPV− STSCC and NSTCC. These findings confirm previous reports and suggest that TSCC subsite may also be of relevance for clinical outcome and should be further followed up in future studies.

Survival of patients with oropharyngeal squamous cell carcinomas (OPSCC) in relation to TNM 8 – Risk of incorrect downstaging of HPV-mediated non-tonsillar, non-base of tongue carcinomas

“…Tonsillar and base of tongue squamous cell carcinomas (TSCC and BOTSCC respectively) showed high HPV prevalence numbers, while carcinomas arising in oropharynx outside the tonsils and base of tongue (otherOPSCC) showed significantly much lower numbers. The latter was in fact, in equivalence with numbers present in oral carcinomas [18,26]. Moreover, previous smaller studies have also suggested a prognostic value of histomorphology context, in which only tumors that arose in a lymphoepithelial context showed a favorable prognosis [4,18].…”

“…The latter was in fact, in equivalence with numbers present in oral carcinomas [18,26]. Moreover, previous smaller studies have also suggested a prognostic value of histomorphology context, in which only tumors that arose in a lymphoepithelial context showed a favorable prognosis [4,18]. Notably is that histomorphology differs between TSCC/BOTSCC and otherOPSCC [27,28].…”

“…Only patients undergoing either primary surgery or primary radiotherapy with/ without chemotherapy with the intention to cure were included in this study. All these patients have previously been included and partly described in smaller previous studies by us [1,18,22,29]. The study was conducted according to ethical permissions obtained from ethical committee, Karolinska institutet.…”

“…The study was conducted according to ethical permissions obtained from ethical committee, Karolinska institutet. p16 and HPV DNA data were collected from previous publications [1,18,22,29]. p16 status was determined by immunohistochemistry using monoclonal antibody (mAb) clone JC8 (Santa Cruz Biotech, Santa Cruz, California, USA), or the mouse mAb E6H4ä clone (CINtec â , Ventana, Tucson, Arizona, USA) on all cases with available tissue biopsies, as described previously.…”

Human papillomavirus and p16 immunostaining, prevalence and prognosis of squamous carcinoma of unknown primary in the head and neck region

“…Of the 17 institution‐matched OPSCC studies, the pooled proportion that was HPV‐positive was 0.60 (95%CI: 0.45–0.74), albeit with high heterogeneity of results across studies ( p heterogeneity <0.0001, I 2 = 0.99). On average, the HPV prevalence of OPSCC was 10% higher than SCCUPHN (95%CI: 1–19%; p < 0.0001; Fig.…”