TNM 8 staging system beyond p16: Double HPV/p16 status is superior to p16 alone in predicting outcome in oropharyngeal squamous cell carcinoma.

Autor: von Buchwald C; Department of Otolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address: Christian.von.buchwald@regionh.dk., Jakobsen KK; Department of Otolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Carlander AF; Department of Otolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Tous S; Epidemiology and Public Health, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain., Grønhøj C; Department of Otolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Rasmussen JH; Department of Otolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Brooks J; Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, UK., Taberna M; Department of Medicine, University of Barcelona, Barcelona, Spain; Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Medical Oncology, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain., Mena M; Epidemiology and Public Health, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain., Morey F; Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain., Bruni L; Epidemiology and Public Health, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain, Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain., Batis N; Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, UK., Brakenhoff RH; Otolaryngology-head and neck surgery, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands., René Leemans C; Otolaryngology-head and neck surgery, Cancer Centre Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands., Jong RJB; Department of Otolaryngology, Head and Neck Surgery, Erasmus MC Cancer Centre, Rotterdam, Netherlands., Klussmann JP; Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany., Wuerdemann N; Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany., Wagner S; Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany., Dalianis T; Department of Oncology-Pathology, Karolinska University Hospital, Stockholm, Sweden., Marklund L; Department of Surgical Sciences, Section of Otolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden; Medical Unit Head and Neck, Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Uppsala, Sweden; Department of Clinical Science, Intervention and Technology, Department of Oto-Rhinolaryngology, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden, Section of Otolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden., Mirghani H; Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France., Schache A; Liverpool Head & Neck Centre, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK., James JA; Regional Molecular Diagnostic Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK; Precision Medicine Centre of Excellence, Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, UK, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK., Huang SH; Department of Radiation Oncology/Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., O'Sullivan B; Department of Radiation Oncology/Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada., Nankivell P; Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, UK., Broglie MA; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Hoffmann M; Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Kiel, Germany., Quabius ES; Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Kiel, Germany., Anderson LA; Aberdeen Centre for Health Data Science, Institute of Applied Health Sciences, University of Aberdeen, Scotland., Craig SG; Regional Molecular Diagnostic Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK; Precision Medicine Centre of Excellence, Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, UK, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK., Alemany L; Department of Medicine, University of Barcelona, Barcelona, Spain; Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Medical Oncology, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain., Mehanna H; Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, UK.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2024 Nov; Vol. 211, pp. 114329. Date of Electronic Publication: 2024 Sep 12.
DOI: 10.1016/j.ejca.2024.114329
Abstrakt: Purpose: The assessment of p16INK4a (p16) in oropharyngeal squamous cell carcinoma (OPSCC) has been incorporated into tumor classification, as p16 has been shown to impact survival probability. However, a recent study demonstrated that human papillomavirus (HPV) status in addition to p16 may have a better discriminatory effect on survival probability. This study aims to determine the impact of combined evaluation of p16 and HPV on prognosis.
Methods: This was a multicenter, multinational analysis including retrospective and prospective cohorts of patients treated for primary OPSCC with curative intent, based on the data of the HNCIG-EPIC study. The primary outcome was to determine how the combined assessment of HPV and p16 status predicts prognosis of patients with OPSCC compared to p16 assessment alone. We employed multivariable analyses models to compute hazard ratios regarding survival. Analyses were stratified by stage, smoking status, and sub-anatomical region.
Results: The study included 7654 patients, with approximately half of the tumors being p16-negative (50.3 %, n = 3849). A total of 9.2 % of patients had discordant p16 and HPV status (n = 704). HPV status significantly impacted overall survival and disease-free survival regardless of p16 status and across both UICC 8th stage I-II and III-IVb cancers. p16-positive/HPV-positive OPSCC patients exhibited the best survival probability.
Conclusion: The detection of HPV had a significant impact on survival probability for OPSCC patients with both p16-positive and p16-negative tumors. HPV testing should be integrated in cancer staging, especially in regions of low attributable fraction, alongside p16 evaluation to ensure a comprehensive assessment of prognosis.
Competing Interests: Declaration of Competing Interest JPK receiving honoraria from MSD, Merck and BMS; research funding from MSD. No other authors have any conflict of interests to declare.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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