BACKGROUND: The presence of human papillomavirus (HPV)-infection in oropharyngeal squamous cell carcinoma (OPSCC) is a major determinant in prognostic risk modeling. However, most risk models are based on clinical trials which only include a selected patient population. The clinical significance of HPV and other prognostic factors in patients with OPSCC remains to be evaluated in a large, unselected cohort, which also includes patients with stage I/II disease and patients with severe comorbidity. PATIENTS AND METHODS: All patients diagnosed with OPSCC in 2000-2006 in two Dutch university hospitals were included. The presence of an oncogenic HPV infection was determined by p16-immunostaining, followed by a high-risk HPV general primer 5+/6+ DNA PCR on the p16-positive cases. Cox regression analysis was carried out to compare survival rates between HPV-positive and HPV-negative patients and a prognostic model was generated by recursive partitioning. RESULTS: In total, 163 of 841 (19.4%) tumors were HPV-positive. Patients with HPV-positive OPSCC had a more favorable overall survival [73.5% versus 40.9% after 5 years; P < 0.001; hazard ratio = 0.34, 95% confidence interval (CI) 0.25-0.48] compared with patients with HPV-negative OPSCC. Patients with p16-positive but HPV DNA-negative tumors showed a significantly less favorable survival than patients with p16-positive and HPV DNA-positive tumors (P < 0.001). A prognostic model was developed in which patients were classified into three risk groups according to HPV status, nodal stage and comorbidity. [Harrell's concordance index of 0.68 (95% CI 0.65-0.71)]. CONCLUSIONS: Tumor HPV status is a strong and independent prognostic factor for survival among patients with OPSCC. A prognostic risk model was proposed, based on our large, unselected cohort of patients with HPV status, comorbidity and nodal stage being the important prognostic factors. In addition, this study emphasizes the importance of performing an HPV DNA-specific test besides p16-immunostaining.
BACKGROUND: The presence of human papillomavirus (HPV)-infection in oropharyngeal squamous cell carcinoma (OPSCC) is a major determinant in prognostic risk modeling. However, most risk models are based on clinical trials which only include a selected patient population. The clinical significance of HPV and other prognostic factors in patients with OPSCC remains to be evaluated in a large, unselected cohort, which also includes patients with stage I/II disease and patients with severe comorbidity. PATIENTS AND METHODS: All patients diagnosed with OPSCC in 2000-2006 in two Dutch university hospitals were included. The presence of an oncogenic HPV infection was determined by p16-immunostaining, followed by a high-risk HPV general primer 5+/6+ DNA PCR on the p16-positive cases. Cox regression analysis was carried out to compare survival rates between HPV-positive and HPV-negative patients and a prognostic model was generated by recursive partitioning. RESULTS: In total, 163 of 841 (19.4%) tumors were HPV-positive. Patients with HPV-positive OPSCC had a more favorable overall survival [73.5% versus 40.9% after 5 years; P < 0.001; hazard ratio = 0.34, 95% confidence interval (CI) 0.25-0.48] compared with patients with HPV-negative OPSCC. Patients with p16-positive but HPV DNA-negative tumors showed a significantly less favorable survival than patients with p16-positive and HPV DNA-positive tumors (P < 0.001). A prognostic model was developed in which patients were classified into three risk groups according to HPV status, nodal stage and comorbidity. [Harrell's concordance index of 0.68 (95% CI 0.65-0.71)]. CONCLUSIONS: Tumor HPV status is a strong and independent prognostic factor for survival among patients with OPSCC. A prognostic risk model was proposed, based on our large, unselected cohort of patients with HPV status, comorbidity and nodal stage being the important prognostic factors. In addition, this study emphasizes the importance of performing an HPV DNA-specific test besides p16-immunostaining.
Authors: Christine H Chung; Qiang Zhang; Christina S Kong; Jonathan Harris; Elana J Fertig; Paul M Harari; Dian Wang; Kevin P Redmond; George Shenouda; Andy Trotti; David Raben; Maura L Gillison; Richard C Jordan; Quynh-Thu Le Journal: J Clin Oncol Date: 2014-09-29 Impact factor: 44.544
Authors: Franziska Hauck; Michelle Oliveira-Silva; Johannes H Dreyer; Victor José Ferreira Perrusi; Roberto Alfonso Arcuri; Rocio Hassan; Cibele Rodrigues Bonvicino; Mario Henrique M Barros; Gerald Niedobitek Journal: Virchows Arch Date: 2015-03-28 Impact factor: 4.064
Authors: Camille Ragin; Monisola Obikoya-Malomo; Sungjin Kim; Zhengjia Chen; Rafael Flores-Obando; Denise Gibbs; Chihaya Koriyama; Francisco Aguayo; Jill Koshiol; Neil E Caporaso; Giovanna E Carpagnano; Marco Ciotti; Hirotoshi Dosaka-Akita; Masashi Fukayama; Akiteru Goto; Demetrios A Spandidos; Vassilis Gorgoulis; Daniëlle A M Heideman; Robert A A van Boerdonk; Kenzo Hiroshima; Reika Iwakawa; Nikolaos G Kastrinakis; Ichiro Kinoshita; Suminori Akiba; Maria T Landi; H Eugene Liu; Jinn-Li Wang; Ranee Mehra; Fadlo R Khuri; Wan-Teck Lim; Taofeek K Owonikoko; Suresh Ramalingam; Emmanuela Sarchianaki; Kari Syrjanen; Ming-Sound Tsao; Jenna Sykes; Siew Wan Hee; Jun Yokota; Apostolos Zaravinos; Emanuela Taioli Journal: Carcinogenesis Date: 2014-02-12 Impact factor: 4.944
Authors: Annekatrin Coordes; Klaus Lenz; Xu Qian; Minoo Lenarz; Andreas M Kaufmann; Andreas E Albers Journal: Eur Arch Otorhinolaryngol Date: 2015-07-31 Impact factor: 2.503