Impact of p16 expression, nodal status, and smoking on oncologic outcomes of patients with head and neck unknown primary squamous cell carcinoma

Peter R Dixon; Michael Au; Ali Hosni; Bayardo Perez-Ordonez; Ilan Weinreb; Wei Xu; Yuyao Song; Shao Hui Huang; Brian O'Sullivan; David P Goldstein; John R de Almeida

doi:10.1002/hed.24441

Impact of p16 expression, nodal status, and smoking on oncologic outcomes of patients with head and neck unknown primary squamous cell carcinoma

Head Neck. 2016 Sep;38(9):1347-53. doi: 10.1002/hed.24441. Epub 2016 Mar 22.

Authors

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada.
² Department of Pathology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada.
³ Department of Biostatistics, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Canada.
⁴ Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.

PMID: 27002481
DOI: 10.1002/hed.24441

Abstract

Background: The prognostic significance of human papillomavirus (HPV) in the context of head and neck squamous cell carcinoma (HNSCC) of cancer of unknown primary (CUP) origin is unclear.

Methods: Patients treated for CUP at the Princess Margaret Cancer Centre between 2001 and 2013 were stratified by p16 status and retrospectively reviewed.

Results: Of the 73 patients included, those with p16-positive tumors (63%) had less advanced nodal status (N1-N2b; 52% vs 89%; p = .035) and less aggressive treatment. Patients with p16-positive tumors had improved 3-year disease-free survival (DFS; 79% vs 56%; p = .012) independent of nodal status and treatment in multivariable analysis (hazard ratio [HR] = 0.27; 95% confidence interval [CI] = 0.08-0.95).

Conclusion: Among patients with CUP, p16-positive status is an independent predictor of DFS but not overall survival (OS). © 2016 Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38: 1347-1353, 2016.

Keywords: head and neck neoplasms; human papilloma virus; p16; squamous cell carcinoma; unknown primary neoplasms.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Aged, 80 and over
Biomarkers, Tumor / metabolism*
Cancer Care Facilities
Carcinoma, Squamous Cell / metabolism*
Carcinoma, Squamous Cell / mortality*
Carcinoma, Squamous Cell / pathology
Carcinoma, Squamous Cell / therapy
Cyclin-Dependent Kinase Inhibitor p16 / metabolism*
Female
Head and Neck Neoplasms / metabolism*
Head and Neck Neoplasms / mortality
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / therapy
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasms, Unknown Primary / mortality
Neoplasms, Unknown Primary / pathology*
Neoplasms, Unknown Primary / therapy
Ontario
Papillomaviridae / isolation & purification
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Registries
Retrospective Studies
Risk Assessment
Smoking / adverse effects
Smoking / mortality
Squamous Cell Carcinoma of Head and Neck
Survival Analysis

Substances

Biomarkers, Tumor
Cyclin-Dependent Kinase Inhibitor p16