A comparison between p16-positive head and neck cancer of unknown primary (HPV-HNCUP) and oropharyngeal squamous cell carcinoma (HPV-OPSCC): are they the same disease?

Autor: Balk M; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany. matthias.balk@uk-erlangen.de., Rupp R; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Sievert M; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Mantsopoulos K; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Allner M; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Grundtner P; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Mueller SK; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Eckstein M; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Krankenhausstraße 8-10, 91054, Erlangen, Germany., Iro H; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany., Hecht M; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Radiation Oncology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Universitätsstraße 27, 91054, Erlangen, Germany., Gostian AO; Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg, Department of Otolaryngology, Head & Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2023 Dec; Vol. 280 (12), pp. 5489-5497. Date of Electronic Publication: 2023 Jul 28.
DOI: 10.1007/s00405-023-08115-5
Abstrakt: Introduction: The following study aimed to answer the question if HPV-HNCUP and HPV-OPSCC are the same disease. Propensity score matching (PSM) was used to compare the oncological outcomes of both groups, in particular the 5-year overall survival rate (OS), the 5-year disease specific survival rate (DSS) and the 5-year progression free survival rate (PFS).
Materials and Methods: Firstly, between January 1st, 2007, and March 31st, 2020 a total of 131 patients were treated with HNCUP at our Department. Out of these, 21 patients with a confirmed positive p16 status were referred to surgery followed by adjuvant therapy. Secondly, between January 1st, 2000, and January 31st, 2017, a total of 1596 patients were treated with an OPSSC at our Department. Out of these, 126 patients with a confirmed positive p16 status were referred to surgery followed by adjuvant therapy. After PSM, 84 patients with HPV-OPSCC and 21 HPV-HNCUP remained in the study for further comparison.
Results: The OS was 63.5% (95% CI 39.4-87.6) for HPV-HNCUP and 88.9% (95% CI 90.4-100.0) for HPV-OPSCC patients and therefore, significantly lower for the first mentioned (p = 0.013). The DSS was also significantly impaired for HPV-HNCUP (71.0%, 95% CI 46.3-95.7), in comparison with HPV-OPSCC patients (95.5%, 95% CI 90.4-100.0; p = 0.002). The PFS for HPV-HNCUP patients was lower (75.6%, 95% CI 54.0-97.2) yet not significantly different to HPV-OPSCC (90.4%, 95% CI 83.5-97.3; p = 0.067).
Conclusions: The results presented demonstrate a significant reduced OS and DSS for HPV-HNCUP patients. Accordingly, in our study HPV-HNCUP and HPV-OPSCC are two different entities with a different oncological outcome.
(© 2023. The Author(s).)
Databáze: MEDLINE
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