Toshiya Maebayashi1, Naoya Ishibashi2, Takuya Aizawa2, Masakuni Sakaguchi2, Tsutomu Saito3, Jiro Kawamori4, Yoshiaki Tanaka5, Yukari Hirotani6, Taku Homma6. 1. Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, 173-8610, Tokyo, Japan. maebayashi.toshiya@nihon-u.ac.jp. 2. Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, 173-8610, Tokyo, Japan. 3. Radiology Clinic, Sonoda Medical Hospital, Adachi-ku, 121-0064, Tokyo, Japan. 4. Department of Radiation Oncology, St. Luke's International Hospital, Chuo-ku, 104-8560, Tokyo, Japan. 5. Department of Radiation Oncology, Kawasaki Saiwai Hospital, 212-0041, Kawasaki, Kanagawa, Japan. 6. Department of Human Pathology, Division of Pathology and Microbiology, Nihon University School of Medicine, Itabashi-ku, 173-8610, Tokyo, Japan.
Abstract
PURPOSE: Treatment guidelines have not been established for unknown primary head and neck squamous cell carcinoma (SCC). For these patients, chemoradiotherapy (CRT) can provide a better prognosis than that for patients with other head and neck cancers. The presence of HPV in the tumor is associated with a better outcome. However, not all patients with HPV-positive unknown primary head and neck SCC experience good treatment outcomes in actual clinical settings. METHODS: We thus retrospectively determined the Ki-67 proliferation index and p16 expression status to assess the associations of these parameters with treatment outcomes of patients with unknown primary head and neck SCC. RESULTS: The subjects were 13 patients who underwent CRT after surgery or excision biopsy between 1999 and 2016. The 2- and 5-year overall survival (OS) rate was 76.9% and 68.4%, respectively. The prognostic factor was age. There was no significant difference in survival between patients with a high Ki-67 vs. low Ki-67 or between patients with p16-positive vs. p16-negative metastases OS. However, all p16-positive patients with low Ki-67 showed good locoregional control. CONCLUSIONS: The combination of ki67 expression and p16 expression status may allow prediction of local control more accurately than p16 expression status alone.
PURPOSE: Treatment guidelines have not been established for unknown primary head and neck squamous cell carcinoma (SCC). For these patients, chemoradiotherapy (CRT) can provide a better prognosis than that for patients with other head and neck cancers. The presence of HPV in the tumor is associated with a better outcome. However, not all patients with HPV-positive unknown primary head and neck SCC experience good treatment outcomes in actual clinical settings. METHODS: We thus retrospectively determined the Ki-67 proliferation index and p16 expression status to assess the associations of these parameters with treatment outcomes of patients with unknown primary head and neck SCC. RESULTS: The subjects were 13 patients who underwent CRT after surgery or excision biopsy between 1999 and 2016. The 2- and 5-year overall survival (OS) rate was 76.9% and 68.4%, respectively. The prognostic factor was age. There was no significant difference in survival between patients with a high Ki-67 vs. low Ki-67 or between patients with p16-positive vs. p16-negative metastases OS. However, all p16-positive patients with low Ki-67 showed good locoregional control. CONCLUSIONS: The combination of ki67 expression and p16 expression status may allow prediction of local control more accurately than p16 expression status alone.
Entities:
Keywords:
Chemoradiotherapy; Ipsilateral oropharynx and neck irradiation; Ki-67; Unknown primary head and neck squamous cell carcinoma; p16
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