Human papillomavirus-associated oropharyngeal cancer: a new clinical entity

Nguyen, Nam P.; Chi, Alexander; Nguyen, Ly M.; Ly, Bevan Hong; Karlsson, Ulf; Vinh-Hung, Vincent

doi:10.1093/qjmed/hcp176

Cited by 39 publications

(40 citation statements)

References 69 publications

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“…A recent study from Sweden reports that while in the 1970s 23 % of tonsillar carcinomas were HPV-positive, 93% positivity was recorded in 2006-2007 [6]. Several authors even suggest an "epidemic" of HPV-positive HNSCCs [7,8].…”

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confidence: 99%

Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16INK4a expression, and HPV status

Laco

Nekvindová²,

Nováková³

et al. 2012

neo

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The aim of this study is to evaluate the biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral (OSCC) and oropharyngeal (OPSCC) squamous cell carcinoma, with emphasis on smoking, protein p16INK4a (p16) expression, and human papillomavirus (HPV) status. The study sample consisted of 48 patients with OSCC and 44 patients with OPSCC. Half of the patients were nonsmokers and the other half were gender-, age-and tumor localization-matched smokers.p16 expression was detected in 17/48 (35 %) OSCCs and in 36/44 (82 %) OPSCCs and HPV DNA was present in 7/48 (15 %) OSCCs and in 35/44 (80 %) OPSCCs. The sensitivity and specificity of p16 expression for HPV DNA presence were 0.74 and 0.88, respectively.The OPSCCs were more frequently basaloid (p < 0.001) while the OSCCs were more frequently conventional (p < 0.000001). The OSCCs were more likely to recur locally and to be the cause of death (p = 0.009 in both parameters).The HPV-positive tumors were more frequently localized in oropharynx, were basaloid SCCs and were p16-and HPV-positive (p < 0.000001 in all 4 parameters). The HPV-negative tumors were more frequently localized in oral cavity (p < 0.000001), more frequently asociated with local, regional and locoregional recurence (p = 0.011, p = 0.019 and p = 0.030, respectively) and with tumor-related death (p = 0.003). There was no significant difference with regard to smoking history (p > 0.05).The survival of patients with HPV-positive tumors was significantly longer (median 112 months; 95% CI 54 -112 months) than that of patients with HPV-negative tumors (median 17 months; 95% CI 12 -39 months) (p < 0.001).The HPV status of OSCC/OPSCC is an important biological and prognostic parameter and should be examined in all cases, using PCR or immunohistochemical detection of surrogate marker p16. Smoking itself does not seem to be an important prognostic factor.

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mentioning

confidence: 99%

Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16INK4a expression, and HPV status

Laco

Nekvindová²,

Nováková³

et al. 2012

neo

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“…Bei HPV-assoziierten Tonsillen-und Zungengrundkarzinomen wurde unabhängig vom Tumorstadium eine deutlich bessere Prognose (5-Jahres-Überlebensrate von 77% in Metaanalyse) als bei noxenassoziierten Karzinomen (entsprechend 42%) belegt [17,26]. Dies ist umso bemerkenswerter, da HPV-assoziierte Karzinome wegen ihrer häufigen primären lymphogenen Metastasierung meist fortgeschrittene Tumorstadien aufweisen.…”

Section: Prognose Und Therapieunclassified

“…Eine günstige Prognose für HPV-assoziierte Karzinome ist sowohl in Studien mit kombinierter Operation und Bestrahlung als auch in Studien mit alleiniger Strahlentherapie, mit alleiniger Operation sowie mit zusätzlicher adjuvanter Chemotherapie gezeigt worden [3,9,13,17]. Daher besteht bis heute kein Konsens über die optimale Therapie von HPV-assoziierten Oropharynxkarzinomen [13].…”

Section: Prognose Und Therapieunclassified

“…Mehrfachkarzinomen wird auf das postulierte Fehlen einer Feldkanzerisierung zurückgeführt. Zudem zeigen HPV-assoziierte Karzinome deutlich weniger Mutationen und damit eine höhere genetische Stabilität [3,7,9,16,17,22,26]. So ist bei HPV-assoziierten Karzinomen nur sehr selten eine inaktivierende Mutation des p53-Gens nachzuweisen (dagegen in 60-80% bei noxenassoziierten Karzinomen), sodass von einem häufig intakten Apoptosemechanismus ausgegangen wird [4,7,9,12,17,30].…”

Section: Prognose Und Therapieunclassified

“…Die letztgenannten Faktoren wurden auch in ursächlichen Zusammenhang mit einem besseren Ansprechen auf Strahlentherapie gebracht [10,12,17,30] …”

Section: Prognose Und Therapieunclassified

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HPV-assoziierte oropharyngeale Karzinome

et al. 2014

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Diese Fortbildungseinheit steht Ihnen als e.CME und e.Tutorial in der Springer Medizin e.Akademie zur Verfügung. -e.CME: kostenfreie Teilnahme im Rahmen des jeweiligen Zeitschriftenabonnements -e.Tutorial: Teilnahme im Rahmen des e.Med-Abonnements ZertifizierungDiese Fortbildungseinheit ist mit 3 CMEPunkten zertifiziert von der Landesärzte-kammer Hessen und der Nord rheinischen Akademie für Ärztliche Fort-und Weiterbildung und damit auch für andere Ärzte-kammern anerkennungsfähig. Hinweis für Leser aus ÖsterreichGemäß dem Diplom-Fortbildungs-Programm (DFP) der Österreichischen Ärzte-kammer werden die in der e.Akademie erworbenen CME-Punkte hierfür 1:1 als fachspezifische Fortbildung anerkannt. Kontakt und weitere Informationen HPV-associated oropharyngeal carcinoma · Status quo and relationship with cancer of unknown primary AbstractCarcinomas of the oropharynx with association to high-risk types of human papillomavirus (HPV) have been identified as a new tumour entity with favourable prognosis, distinct from classical nicotine-and alcohol-associated carcinoma. They develop through oncogenic transformation of the basal cells of reticulated cryptal epithelium of the palatinal tonsils and the base of the tongue. Positivity for HPV strongly correlates with an atypical, non-keratinizing histological differentiation and cystic transformation of lymph node metastases. Strong immunohistological positivity for p16 reliably detects transcriptionally active infection with high-risk HPV. Hence, p16 staining has been regarded as an effectual diagnostic tool in the appropriate setting.Frequent nodal metastasation as well as considerable size of (cystic) metastases, and frequent small size as well as submucosal location of primary tumours all contribute to frequent initial manifestation of cervical cancer of unknown primary (CUP). In a situation of CUP diagnostic testing for HPV (in negative cases in addition to EBV) is recommended in lymph node metastases, due to the high predictive value for the localization of occult primary carcinomas. Intense clinicopathological cooperation is mandatory for improved detection of small, occult primary carcinomas. The relevance of this new carcinoma entity will increase, as the incidence continues to increase worldwide.

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Asymptomatic p16-Positive Oropharyngeal Squamous Cell Carcinoma

Sand

Haughey

Nussenbaum

2014

JAMA Otolaryngol Head Neck Surg

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With the rise of p16-positive oropharyngeal squamous cell carcinoma and lack of screening technologies for early-stage disease, purely incidentally diagnosed disease might increase in incidence. These findings underscore the importance of a comprehensive physical examination on all patients. Although follow-up is too limited for definitive conclusions, early experience suggests that these patients can be treated with unimodality therapy when presenting with stage I or II disease.

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Human papillomavirus-associated oropharyngeal cancer: a new clinical entity

Cited by 39 publications

References 69 publications

Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16INK4a expression, and HPV status

Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16INK4a expression, and HPV status

HPV-assoziierte oropharyngeale Karzinome

Asymptomatic p16-Positive Oropharyngeal Squamous Cell Carcinoma

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