Human Papillomavirus Reduces The Prognostic Value Of Nodal Involvement In Tonsillar Squamous Cell Carcinomas.
J. Straetmans, N. Olthof, J. J. Mooren, J. D. de Jong, E. Speel, B. Kremer
Published 2009 · Medicine
Download PDFAnalyze on Scholarcy
OBJECTIVES/HYPOTHESIS Assessment of the prognostic value of nodal status in relation to human papillomavirus (HPV) status and the various treatment modalities in tonsillar squamous cell carcinomas (TSCC). STUDY DESIGN Retrospective 5-year survival analysis. METHODS A 5-year follow-up of disease-free, disease-specific, and overall survival in a group of 81 patients with TSCC was conducted. The nodal status and integration of HPV-DNA in the genome (detected with fluorescence in situ hybridization) as prognostic indicators were examined while correcting for other clinical parameters (smoking habits, alcohol consumption, treatment modality, differentiation, TNM classification). RESULTS Of TSCCs, 41% were positive for HPV type 16. In these TSCCs, the primary tumor was significantly smaller when compared to HVP-negative TSCCs (P = .04), whereas the percentage of cases with cervical metastases was identical. In the total population, it was not nodal involvement, but rather HPV manifestation, which was related to patient prognosis. Within the treatment modalities (surgery combined with radiotherapy and radiotherapy alone), neither nodal status nor HPV were prognostic indicators. CONCLUSIONS Since a substantial percentage of TSCCs are HPV-positive and metastasizes to cervical lymph nodes in less advanced primary tumors, the N status is an unreliable prognostic indicator in TSCCs. HPV is only prognostically relevant in the total tumor population, but loses its value within patient groups receiving a single treatment modality. The value of HPV for prognosis of patients with TSCC requires further study.
This paper references
Role of human papillomavirus in the development of head and neck squamous cell carcinomas
H. Hafkamp (2004)
Einfluß verschiedener Formen des metastatischen Lymphknotenbefalls auf die Prognose von Plattenepithelkarzinomen im oberen Aerodigestivtrakt
W. Kehrl (1998)
Use of decision analysis in planning a management strategy for the stage N0 neck.
M. H. Weiss (1994)
HPV status and regional metastasis in the prognosis of oral and oropharyngeal cancer
J. Klozar (2007)
Human papillomavirus positive squamous cell carcinoma of the oropharynx
K. Lindel (2001)
Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial.
C. Fakhry (2008)
Staging of the neck in patients with head and neck squamous cell cancer: imaging techniques and biomarkers.
R. Takes (2004)
Correlation between prognosis and degree of lymph node involvement in carcinoma of the head and neck.
I. Ono (1985)
The influence of lymph node metastasis in the treatment of squamous cell carcinoma of the oral cavity, oropharynx, larynx, and hypopharynx: N0 versus N+.
Michael K Layland (2005)
Prognostic impact of complete remission after preoperative irradiation of tonsillar carcinoma: a retrospective analysis of the radiumhemmet data, 1980-1995.
S. Friesland (1999)
Carcinoma of the oropharynx: factors affecting outcome.
K. Sundaram (2005)
Evidence for a causal association between human papillomavirus and a subset of head and neck cancers.
M. Gillison (2000)
Correlation between prognosis and degree of lymph node involvement in carcinoma of the oral cavity.
I. Kalnins (1977)
Prevalence, distribution, and viral load of human papillomavirus 16 DNA in tonsillar carcinomas
J. Klussmann (2001)
Elective management of the clinically negative neck by otolaryngologists in patients with oral tongue cancer.
J. Werning (2003)
Molecular classification identifies a subset of human papillomavirus--associated oropharyngeal cancers with favorable prognosis.
P. Weinberger (2006)
Human papillomavirus-16 associated squamous cell carcinoma of the head and neck (SCCHN): a natural disease model provides insights into viral carcinogenesis.
R. Ferris (2005)
[Neck lymph node dissection in squamous cell carcinoma originating in the head-and-neck area; the significance for the prognosis].
C. R. Leemans (1992)
Carcinoma of the tonsil: prognostic factors.
S. Alabdulwahed (1997)
Human papillomavirus (HPV) DNA in tonsillar cancer: Clinical correlates, risk of relapse, and survival
H. Mellin (2000)
Lymph node metastases from laryngeal and pharyngeal carcinomas--calculation of burden of metastasis and its impact on prognosis.
J. Jakobsen (1998)
Survival of squamous cell carcinoma of the head and neck in relation to human papillomavirus infection: Review and meta‐analysis
C. Ragin (2007)
Nonparametric Estimation from Incomplete Observations
E. L. Kaplan (1958)
Marked differences in survival rate between smokers and nonsmokers with HPV 16‐associated tonsillar carcinomas
H. Hafkamp (2008)
Der Einfluß von Tumorgröße, Lymphknotenbefall und Behandlungsart auf die Prognose des Hypopharynxkarzinoms
U. Ganzer (1982)
Cervical nodal metastases in squamous cell carcinoma of the head and neck: What to expect
S. Mukherji (2001)
Human papillomavirus E6 and E7 oncoproteins alter cell cycle progression but not radiosensitivity of carcinoma cells treated with low-dose-rate radiation.
T. Deweese (1997)
Clinical implications of human papillomavirus in head and neck cancers.
C. Fakhry (2006)
A subset of head and neck squamous cell carcinomas exhibits integration of HPV 16/18 DNA and overexpression of p16INK4A and p53 in the absence of mutations in p53 exons 5–8
Harriet C Hafkamp (2003)
Neck dissection: then and now.
A. Ferlito (2006)
Human papillomavirus 16 and head and neck squamous cell carcinoma
C. S. Furniss (2007)
Reduction of the number of neck treatments in patients with head and neck cancer
Robert J. Baatenburg de Jong (1993)
This paper is referenced by
Is HPV‐Associated Oropharyngeal Cancer Becoming More Common in Older Patients?
James D Thompson (2018)
Radiothérapie des cancers oto-rhino-laryngologiques
R. Bensadoun (2013)
Cystic masses of the lateral neck - Proposition of an algorithm for increased treatment efficiency.
Evamaria Koch (2018)
Primary surgery for oropharyngeal cancer
Ross A. Udoff (2010)
[A clinical study of cases diagnosed as being oropharyngeal carcinoma after cervical mass extirpation/biopsy].
T. Mizumachi (2014)
Human Papillomavirus-related Oropharyngeal Carcinoma: Current Understanding and Enduring Uncertainties.
Shao Hui Huang (2011)
Prognostic factors and survival unique to surgically treated p16+ oropharyngeal cancer.
B. Haughey (2012)
Papillomavirus humain et cancer ORL
Binta Barry (2014)
HPV-Mediated (p16+) Oropharyngeal Cancer
B. O'Sullivan (2017)
Prevalence of Human Papillomavirus in Oropharyngeal Cancer: A Multicenter Study in Japan
Takanori Hama (2014)
New horizons in lymph node imaging in head and neck cancer
R.B.J. de Bondt (2010)
Radioterapia de los cánceres otorrinolaringológicos
R. -J. Bensadoun (2013)
Treatment outcomes in oropharynx cancer patients who did not complete planned curative radiotherapy.
F. Alfaraj (2019)
The interplay of IMRT and transoral surgery in HPV-mediated oropharyngeal cancer: Getting the balance right.
S. Huang (2018)
Prevalence of HPV infection in racial-ethnic subgroups of head and neck cancer patients.
C. Ragin (2016)
Diagnosis of Bilateral Tonsil Cancers via Staging PET/CT: Case Report and Review
E. Mannina (2011)
HPV-Associated Head and Neck Cancer: Unique Features of Epidemiology and Clinical Management.
J. Maxwell (2016)
HPV – A different view on Head and Neck Cancer
Claus Wittekindt (2018)
Molecular signatures and prognosis of HPV-positive head and neck lesions
Jeroen J. Mooren (2014)
Treatment-Related Patient Outcomes for Head and Neck Cancer
Ameya A. Jategaonkar (2020)
Valoración de la capacidad pronóstica de la afectación ganglionar de los pacientes con carcinoma de orofaringe en función del estatus HPV
J. Nicolau Costa (2020)
ACR Appropriateness Criteria® Locoregional therapy for resectable oropharyngeal squamous cell carcinomas
J. Beitler (2016)
Validation of the eighth edition American Joint Committee on Cancer staging system for human papillomavirus‐associated oropharyngeal cancer
John D Cramer (2018)
HPV infection and integration in oropharyngeal squamous cell carcinomas
Nadine C. Olthof (2013)
Next-generation treatment strategies for human papillomavirus-related head and neck squamous cell carcinoma: where do we go?
N. Olthof (2012)
Human papillomavirus related head and neck cancer survival: a systematic review and meta-analysis.
M. O'Rorke (2012)
[Human papilloma virus in head and neck cancer].
B. Barry (2014)
The Current State of Biological and Clinical Implications of Human Papillomavirus-Related Oropharyngeal Cancer.
Shao Hui Huang (2018)
Prevalence of HPV infection in racial–ethnic subgroups of head and neck cancer patients
C. Ragin (2016)
HPV status in patients with head and neck of carcinoma of unknown primary site: HPV, tobacco smoking, and outcome.
S. Tribius (2012)
Overview of the 8th Edition TNM Classification for Head and Neck Cancer
S. H. Huang (2017)
atment strategies for human ted head and neck squamous cell carcinoma : where do we go ?
Nadine C. Olthof (2012)See more