In:
British Journal of Cancer, Springer Science and Business Media LLC, Vol. 123, No. 7 ( 2020-09-29), p. 1114-1122
Abstract:
A remarkably better prognosis is associated with oropharyngeal squamous cell carcinomas (OPSCC) driven by human papillomaviruses (HPV) compared with HPV-negative OPSCC. Consequently, de-escalation of standard treatment has been suggested. Due to modest specificity rates, debates are ongoing, whether p16 INK4a , a surrogate marker for HPV-driven OPSCC, is sufficient to correctly identify those tumours and avoid substantial HPV misattribution and thus undertreatment of patients by de-escalation. Robust data estimating the proportion of potentially undertreated patients are missing. Methods We assessed a large-scale cohort of consecutively included OPSCC diagnosed between 2000 and 2017 for HPV–DNA, HPV genotypes, p16 INK4a expression and multiple tumour- and patient-related risk factors, and investigated their impact on patients’ survival in comprehensive uni- and multivariate analyses. Results Aetiological relevance of HPV (p16 INK4a - and high-risk HPV–DNA-positivity) was detected in 27.1% ( n = 192) of OPSCC, with HPV 16 being the most abundant HPV type (94.6%). In 5.5% patients ( n = 39), p16 INK4a overexpression but no HPV–DNA was detected. Principal component and survival analyses revealed that 60.6% of these p16 INK4a -positive OPSCC lacking HPV–DNA did not resemble HPV 16 -driven but HPV-negative OPSCC regarding risk-factor profile and overall survival. Notably, this group represented 10.6% of all p16 INK4a -overexpressing OPSCC. Conclusions p16 INK4a as a single marker appears insufficient to indicate OPSCC patients suitable for treatment de-escalation.
Type of Medium:
Online Resource
ISSN:
0007-0920
,
1532-1827
DOI:
10.1038/s41416-020-0964-x
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2020
detail.hit.zdb_id:
2002452-6
detail.hit.zdb_id:
80075-2
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