Prognostic impact of additional HPV diagnostics in 102 patients with p16-stratified advanced oropharyngeal squamous cell
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HEAD AND NECK
Prognostic impact of additional HPV diagnostics in 102 patients with p16‑stratified advanced oropharyngeal squamous cell carcinoma Bernhard G. Weiss1 · Mahalia Zoe Anczykowski2 · Stefan Küffer4 · Jennifer L. Spiegel1 · Mattis Bertlich1 · Martin Canis1 · Friedrich Ihler1,3 · Julia Kitz4 · Mark Jakob1 Received: 30 April 2020 / Accepted: 30 July 2020 © The Author(s) 2020
Abstract Purpose p16 overexpression was considered as surrogate marker to identify human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCCs). Methods 102 patients with advanced stage OPSCCs treated primarily by transoral lasermicrosurgery were included. Prognostic associations of p16- and HPV-status were analyzed separately and combined. Results In contrast to p16, the HPV-status resulted in no significant survival discrepancies (5-year overall survival (OS) HPV-positive 64.9%, HPV-negative 78.7%). Combining both markers, p16-positive (p16-positive/HPV-positive, p16-positive/ HPV-negative) and p16-negative/HPV-negative groups demonstrated comparable high survival (OS 78.1% vs. 85.6% vs. 73.6%). Lowest survival was observed for patients with p16-negative/HPV-positive OPSCCs (OS 40.8%). Never smoking patients with p16-positive OPSCCs demonstrated the highest survival, whereas within former/current smokers with p16-positive and p16-negative disease it was comparable low (OS 90.0% vs. 63.0% vs. 57.4%). Conclusions p16- and HPV-status should not be considered as equivalent markers for a better prognosis. Furthermore, they should not generally predominate patient associated factors like smoking. Keywords Oropharyngeal squamous cell carcinoma · Oropharyngeal cancer · p16 · Human papillomavirus (HPV) · Prognosis · Head and neck squamous cell carcinomas (HNSCC)
Introduction Bernhard G. Weiss, Mahalia Zoe Anczykowski, Julia Kitz and Mark Jakob have contributed equally. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06262-7) contains supplementary material, which is available to authorized users. * Bernhard G. Weiss [email protected]‑muenchen.de 1
Department of Otorhinolaryngology, LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
2
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Robert‑Koch‑Str. 40, 37075 Göttingen, Germany
3
German Center for Vertigo and Balance Disorders (DSGZ), LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Federal Republic of Germany
4
Institute of Pathology, University Medical Center Göttingen, Robert‑Koch‑Str. 40, 37075 Göttingen, Germany
Oropharyngeal cancer constitutes 11.3% of all head and neck malignancies [1]. Apart from the most prevalent risk factors of alcohol and tobacco consumption [2], a geographical divergent increasing subset of oropharyngeal squamous cell carcinomas (OPSCC) is characterized by human papillomavirus (HPV) infections [3–8]
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