Prognostic impact of human papillomavirus status, survivin, and epidermal growth factor receptor expression on survival in patients treated with radiochemotherapy for very advanced nonresectable oropharyngeal cancer

Semrau, R.; Duerbaum, H.; Temming, Susanne; Huebbers, Christian U.; Stenner, Markus; Drebber, Uta; Klußmann, Jens Peter; Müller, Rolf-Peter; Preuss, Simon F.

doi:10.1002/hed.23126

Cited by 26 publications

(19 citation statements)

References 33 publications

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“…The various cutoffs used for defining p16 overexpression have contributed to substantial variation in the level of concordance with direct HPV testing. The HPV and p16 concordance of our study is on the higher end (92%) among studies that employed the HPV DNA PCR approach (61-100%), but is similar to large studies (n > 100) with a defined p16 IHC cutoff of >50% (80-97% concordance) [17,22,[24][25][26][27][28][29]31,36,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55]. In a recent meta-analysis of OPSCC correlating HPV detected by DNA PCR and/or ISH and p16 (n = 2888), the highest correlation between HPV and p16 was for p16 IHC staining >70% rather than a verbal definition or a lower percentage.…”

Section: Discussionsupporting

confidence: 75%

Correlation of p16 expression and HPV type with survival in oropharyngeal squamous cell cancer

et al. 2015

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Section: Discussionsupporting

confidence: 75%

Correlation of p16 expression and HPV type with survival in oropharyngeal squamous cell cancer

et al. 2015

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“…In consequence, the majority of patients with T4a carcinoma treated in Germany are HPV-negative OPSCC. Our study is consistent with previous work that demonstrated worse survival rates for HPV-negative patients [5, 21, 25]. Although our results were not statistically significant, this can be attributed to the small number of p16-positive patients.…”

Section: Discussionsupporting

confidence: 92%

“…There are two explanations for this phenomenon: first, the relatively low proportion of HPV-related oropharyngeal carcinoma in Germany compared to other regions [25] and second, the advanced T category. Patients with HPV-related carcinoma are younger and more discerning and therefore seek medical help before the tumor becomes locally advanced (T4a) [17].…”

Section: Discussionmentioning

confidence: 99%

Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection

Psychogios

Mantsopoulos

Agaimy³

et al. 2014

BioMed Research International

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Background. The prognosis of patients with advanced oropharyngeal carcinoma (OPSCC) is generally poor. The aim of this study is to investigate the different therapeutic approaches and identify prognostic factors associated with a worse outcome for patients treated for T4a OPSCC, in order to improve treatment selection for the individual. Methods. A retrospective study was conducted on 426 patients with T4a OPC treated between 1980 and 2010. Eleven prognostic factors including treatment modality, lymph node staging, and p16 status as a surrogate marker for human papillomavirus (HPV) infection were analyzed. Results. Univariate analysis showed a significant difference in DSS between N0 and N+ (57.1% versus 26.9%, P < 0.001), primary surgical and primary nonsurgical treatment (52.7% versus 31.4%, P < 0.001), and perinodal invasion (51.7% versus 19.9%, P = 0.011). P16-negative patients tended towards a worse DSS than p16-positive patients (40.2% versus 64.6%, P = 0.126) but responded better to primary surgery than to nonsurgical treatment (71.4% versus 34.0%, P = 0.113). Multivariate analysis identified the N category as an independent prognostic factor for survival. Conclusion. The survival of p16-negative patients was worse than p16-positive patients, although they seem to respond better to primary surgery. The strongest independent prognostic factor for T4a carcinomas proved to be the presence of lymph node metastases.

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“…Nevertheless, in patients with advanced non-resectable tumors, HPV status had a positive impact on progression-free survival but not on overall survival [58]. This indicates that in subsets of HPV-related HNSCC, additional factors may overcome the influence of HPV, and stratification strategies have to be refined.…”

Section: Hpv Diagnostics Patient Survival and Treatmentmentioning

confidence: 99%

Human Papillomavirus-Related Head and Neck Cancer

Wagner¹,

Sharma²,

Wuerdemann³

et al. 2017

Oncol Res Treat

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Human papillomavirus(HPV)-related head and neck cancer is recognized as a distinct tumor entity with rising incidence reported for several countries. These tumors arise from squamous cells, typically in the oropharynx. In contrast to cancer associated with other risk factors, HPV-related cancer is driven by viral oncoprotein activity and has individual profiles regarding protein expression, and genetic and epigenetic alterations. Molecular characteristics are p16^IN4A overexpression, absence of p53 inactivating mutations, and PI3K/AKT and Wnt pathway modulation. Patients with HPV-related head and neck cancer have improved survival compared to those with HPV-negative tumors, and p16^INK4A staining has been introduced into tumor staging recently. However, no specific or toxicity-reduced treatment modalities have been established for this entity so far. Although the still incomplete and partially inconsistent data in this field needs further study, particular features of HPV-related cancers such as specific microRNA expression, immunology, or gene methylation patterns certainly have the potential to be implemented in future diagnostic and therapeutic concepts.

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Prognostic impact of human papillomavirus status, survivin, and epidermal growth factor receptor expression on survival in patients treated with radiochemotherapy for very advanced nonresectable oropharyngeal cancer

Abstract: HPV status influences PFS in patients with advanced, nonresectable tumor stages but not OS. Additional risk factors seem to have a stronger influence on survival than HPV status.

Cited by 26 publications

References 33 publications

Correlation of p16 expression and HPV type with survival in oropharyngeal squamous cell cancer

Correlation of p16 expression and HPV type with survival in oropharyngeal squamous cell cancer

Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection

Human Papillomavirus-Related Head and Neck Cancer

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