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Kornfeld B, Taha A, Kyang L, Sim HW, Dewhurst S, McCloy R, Chin V, Earls P, Parker A, Leavers B, Forstner D, Floros P, Crawford J, Gallagher R. Oncological outcomes post transoral robotic surgery (TORS) for HPV-associated oropharyngeal squamous cell carcinoma, a single-centre retrospective Australian study. J Robot Surg 2024; 18:226. [PMID: 38806847 PMCID: PMC11133022 DOI: 10.1007/s11701-024-01910-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/09/2024] [Indexed: 05/30/2024]
Abstract
We present a cohort review of TORS resection for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) and its associated oncological outcomes spanning a 10-year period. A retrospective case series review was performed of patients undergoing primary surgical treatment for HPV-associated OPSCC through the St. Vincent's Head and Neck Cancer service from 2011 to 2022. The primary outcomes were to investigate complete resection of the primary tumour, rates of recurrence, and survival analysis. Secondary outcomes included complications, rates of adjuvant therapy, sites of recurrence and rates of percutaneous endoscopic gastrostomy (PEG). 184 patients underwent TORS-based therapy with neck dissection, and guideline-directed adjuvant therapy for HPV-associated OPSCC. Our median follow-up was 46 months. The positive margin rate on final histopathology analysis was 10.9%. Adjuvant therapy was indicated in 85 patients (46%). The local recurrence rate was 10.9% with the majority (80%) of patients recurring in the first 3 years since treatment. The disease-specific survival at 3 years was 98.6% and at 5 years was 94.4%. The 3-year and 5-year OS for the cohort was 96.7% and 92.5%, respectively. The presence of extranodal extension and positive margins were associated with increased risk of recurrence, whereas adjuvant therapy was found to be a protective factor for both overall recurrence and survival. Major complications occurred in 12 patients (6.5%), resulting in one death. This study has demonstrated that primary surgical therapy for HPV-associated OPSCC is a safe and effective treatment modality with low local recurrence and complication rates, and overall survival benefits.
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Affiliation(s)
- Belen Kornfeld
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia.
- Faculty of Medicine and Health, University of New South Wales, High St, Sydney, NSW, 2052, Australia.
- Department of Medicine, Notre Dame University, Sydney, NSW, 2010, Australia.
| | - Ahmed Taha
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Lee Kyang
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Hao-Wen Sim
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
- Faculty of Medicine and Health, University of New South Wales, High St, Sydney, NSW, 2052, Australia
- The Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW, 2010, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, 370 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Suzannah Dewhurst
- Faculty of Medicine and Health, University of New South Wales, High St, Sydney, NSW, 2052, Australia
| | - Rachael McCloy
- The Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Vanessa Chin
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
- The Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW, 2010, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, 370 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Peter Earls
- Department of Anatomical Pathology, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Andrew Parker
- Department of Anatomical Pathology, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Brett Leavers
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Dion Forstner
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, 370 Victoria St, Darlinghurst, NSW, 2010, Australia
- GenesisCare, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Peter Floros
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Julia Crawford
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
| | - Richard Gallagher
- Department of Otolaryngology, Head and Neck Surgery, St. Vincent's Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia
- School of Medicine, Notre Dame University, 160 Oxford St, Darlinghurst, NSW, 2010, Australia
- The Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW, 2010, Australia
- Department of Medical Oncology, The Kinghorn Cancer Centre, 370 Victoria St, Darlinghurst, NSW, 2010, Australia
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Glaß M, Hüttelmaier S. IGF2BP1-An Oncofetal RNA-Binding Protein Fuels Tumor Virus Propagation. Viruses 2023; 15:1431. [PMID: 37515119 PMCID: PMC10385356 DOI: 10.3390/v15071431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
The oncofetal RNA-binding protein IGF2BP1 has been reported to be a driver of tumor progression in a multitude of cancer entities. Its main function is the stabilization of target transcripts by shielding these from miRNA-mediated degradation. However, there is growing evidence that several virus species recruit IGF2BP1 to promote their propagation. In particular, tumor-promoting viruses, such as hepatitis B/C and human papillomaviruses, benefit from IGF2BP1. Moreover, recent evidence suggests that non-oncogenic viruses, such as SARS-CoV-2, also take advantage of IGF2BP1. The only virus inhibited by IGF2BP1 reported to date is HIV-1. This review summarizes the current knowledge about the interactions between IGF2BP1 and different virus species. It further recapitulates several findings by presenting analyses from publicly available high-throughput datasets.
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Affiliation(s)
- Markus Glaß
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3a, 06120 Halle, Germany
| | - Stefan Hüttelmaier
- Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3a, 06120 Halle, Germany
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López-Ansio M, Ramos-García P, González-Moles MÁ. Prognostic and Clinicopathological Significance of the Loss of Expression of Retinoblastoma Protein (pRb) in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:3132. [PMID: 37370742 DOI: 10.3390/cancers15123132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
This systematic review and meta-analysis aims to evaluate the scientific evidence on the implications of retinoblastoma protein (pRb) alterations in oral cancer, in order to determine its prognostic and clinicopathological significance. PubMed, Embase, Web of Science, and Scopus were searched for studies published before February 2022, with no restrictions by publication date or language. The quality of the studies using the Quality in Prognosis Studies tool (QUIPS tool). Meta-analysis was conducted to achieve the proposed objectives, as well as heterogeneity, subgroup, meta-regression, and small study-effects analyses. Twenty studies that met the inclusion criteria (2451 patients) were systematically reviewed and meta-analyzed. Our results were significant for the association between the loss of pRb expression and a better overall survival (HR = 0.79, 95%CI = 0.64-0.98, p = 0.03), whereas no significant results were found for disease-free survival or clinico-pathological parameters (T/N status, clinical stage, histological grade). In conclusion, our evidence-based results demonstrate that loss of pRb function is a factor associated with improved survival in patients with OSCC. Research lines that should be developed in the future are highlighted.
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Affiliation(s)
- María López-Ansio
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Panda NK, Kapoor A, Goel N, Ghoshal S, Singh V, Bal A. Analysis of Outcomes following TORS in a Mixed Cohort of Recurrent and New T1-T2 Oropharyngeal Cancer- A Single Institution Study. Indian J Otolaryngol Head Neck Surg 2022; 74:555-563. [PMID: 36514439 PMCID: PMC9741672 DOI: 10.1007/s12070-022-03139-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/13/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose . The transoral robotic surgery is a newer modality being used in surgical treatment of early oropharyngeal cancer. The aim of this study is to assess the outcome of these cases in terms of two year disease free survival and overall survival. Methods Between July 2016 and September 2018, 58 patients suffering from early oropharyngeal cancer underwent transoral robotic surgery with neck dissection at a tertiary referral centre. 43 of them have completed two years follow up and were analyzed for disease free survival and overall survival. 41 patients had HPV analysis done . Results The surgical margins were positive in 9/43 patients ( 6 in upfront surgery and 3 in the salvage cohort). Adjuvant therapy was administered to 16/34 patients on account of either positive margins or multiple nodal metastasis. 88% patients were found to be HPV negative. The two year disease free survival for the upfront cohort was 88.2% and salvage cohort was 55.5%. The overall survival was 86.05%. Conclusions The study highlights good locoregional control and two year disease free survival in HPV negative oropharyngeal cancer undergoing robotic surgery. Additionally, a positive surgical margin and recurrence were the statistically significant variables influencing 2 year disease free survival. Trans oral robotic surgery is an excellent tool for early tumors of the oropharynx. The presence of a positive surgical margin is a grim sign for survival and has a significant impact on positive outcome. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03139-5.
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Affiliation(s)
- Naresh K Panda
- Professor and Head Department of Otolaryngology Head Neck Surgery PGIMER, 160012 Chandigarh, India
| | - Archit Kapoor
- Professor and Head Department of Otolaryngology Head Neck Surgery PGIMER, 160012 Chandigarh, India
| | - Nitika Goel
- Professor and Head Department of Otolaryngology Head Neck Surgery PGIMER, 160012 Chandigarh, India
| | - Sushmita Ghoshal
- Professor and Head Department of Otolaryngology Head Neck Surgery PGIMER, 160012 Chandigarh, India
| | - Varinder Singh
- Professor and Head Department of Otolaryngology Head Neck Surgery PGIMER, 160012 Chandigarh, India
| | - Amanjit Bal
- Professor and Head Department of Otolaryngology Head Neck Surgery PGIMER, 160012 Chandigarh, India
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Ward BJH, Schaal DL, Nkadi EH, Scott RS. EBV Association with Lymphomas and Carcinomas in the Oral Compartment. Viruses 2022; 14:v14122700. [PMID: 36560704 PMCID: PMC9783324 DOI: 10.3390/v14122700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Epstein-Barr virus (EBV) is an oncogenic human herpesvirus infecting approximately 90% of the world's population. The oral cavity serves a central role in the life cycle, transmission, and pathogenesis of EBV. Transmitted to a new host via saliva, EBV circulates between cellular compartments within oral lymphoid tissues. Epithelial cells primarily support productive viral replication, while B lymphocytes support viral latency and reactivation. EBV infections are typically asymptomatic and benign; however, the latent virus is associated with multiple lymphomas and carcinomas arising in the oral cavity. EBV association with cancer is complex as histologically similar cancers often test negative for the virus. However, the presence of EBV is associated with distinct features in certain cancers. The intrinsic ability of EBV to immortalize B-lymphocytes, via manipulation of survival and growth signaling, further implicates the virus as an oncogenic cofactor. A distinct mutational profile and burden have been observed in EBV-positive compared to EBV-negative tumors, suggesting that viral infection can drive alternative pathways that converge on oncogenesis. Taken together, EBV is also an important prognostic biomarker that can direct alternative therapeutic approaches. Here, we discuss the prevalence of EBV in oral malignancies and the EBV-dependent mechanisms associated with tumorigenesis.
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Benzerdjeb N, Tantot J, Blanchet C, Philouze P, Mekki Y, Lopez J, Devouassoux-Shisheboran M. Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumour status. Histopathology 2021; 79:381-390. [PMID: 33560536 DOI: 10.1111/his.14350] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/02/2021] [Accepted: 02/06/2021] [Indexed: 12/13/2022]
Abstract
AIMS Oropharyngeal squamous cell carcinomas (OPSCC) related to human papillomavirus (HPV) infection have a better prognosis than those without HPV infection. Although p16INK4a overexpression is used as a surrogate marker for HPV infection, 5-20% of p16-positive OPSCC are described as being unrelated to HPV infection, with worse overall survival compared to OPSCC-related HPV. There is therefore a risk of undertreating a proportion of OPSCC patients falsely considered to be HPV-driven because of p16 positivity. TP53 mutations are highly prevalent in OPSCC driven by mutagens in tobacco and alcohol. We describe herein a combined p16/p53 algorithm to predict HPV tumour status in OPSCC. METHODS AND RESULTS A total of 110 OPSCC were identified in the database of the pathology department and were studied using p16 and p53 immunohistochemistry. For p16-positive or p16-negative/wild-type patterns-p53 (WT-p53) cases (n = 63), DNA in-situ hybridisation for high-risk HPV was performed, and if negative the HPV status was controlled by HPV DNA polymerase chain reaction (PCR) (n = 19). A significant association between TP53 mutation and pattern of p53 expression was found (WT-p53, seven of 16, P < 0.001). The p16-positive/WT-p53 was significantly associated with HPV+ tumour status (p16-positive/WT-p53, 50 of 110, P < 0.001). Interestingly, a subset of p16-positive OPSCC was unrelated to HPV (13.5%, eight of 59), and showed mutant-type staining of p53 expression. CONCLUSIONS The p16 protein immunopositivity in conjunction with the mutant-type pattern of p53 staining helped to reclassify a subset of p16-positive OPSCC as OPSCC-unrelated HPV. This approach could be routinely applied by pathologists involved in the management of OPSCC, because of their potential therapeutic implications.
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Affiliation(s)
- Nazim Benzerdjeb
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Université Lyon 1, Villeurbanne, Hôpital La Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Juliet Tantot
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Christophe Blanchet
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Université Lyon 1, Villeurbanne, Hôpital La Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Pierre Philouze
- Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital La Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Yahia Mekki
- Laboratoire de Virologie, Institut des Agents Infectieux, Centre de Biologie et de Pathologie Nord, Hospices Civils de Lyon, Lyon, France
| | - Jonathan Lopez
- Biochemistry and Molecular Biology Department, Hospital Lyon-Sud, Université Lyon I, Lyon, Pierre-Bénite, France
| | - Mojgan Devouassoux-Shisheboran
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Université Lyon 1, Villeurbanne, Hôpital La Croix Rousse, Hospices Civils de Lyon, Lyon, France
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Lorenzatti Hiles G, Chang KP, Bellile EL, Wang CI, Yen WC, Goudsmit CM, Briggs HL, Thomas TB, Peters L, Afsari MA, Pinatti LM, Morris AC, Jawad N, Carey TE, Walline HM. Understanding the impact of high-risk human papillomavirus on oropharyngeal squamous cell carcinomas in Taiwan: A retrospective cohort study. PLoS One 2021; 16:e0250530. [PMID: 33891627 PMCID: PMC8064583 DOI: 10.1371/journal.pone.0250530] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally. In Taiwan, HPV-positive OPSCC is obscured by tobacco, alcohol, and betel quid use. We investigated the role of high-risk HPV (hrHPV) in a large retrospective Taiwan OPSCC cohort. METHODS AND RESULTS The cohort of 541 OPSCCs treated at Chang Gung Memorial Hospital from 1998-2016 consisted of 507 men (94%) and 34 women (6%). Most used tobacco (81%), alcohol (51%), and betel quid (65%). Formalin-fixed, paraffin-embedded tissue was used for p16 staining (a surrogate marker for HPV) and testing for HPV DNA presence and type by Multiplex HPV PCR-MassArray. HPV DNA and/or p16 staining (HPV-positive) was found in 28.4% (150/528) tumors. p16 and HPV DNA were strongly correlated (F < 0.0001). HPV16 was present in 82.8%, and HPV58 in 7.5% of HPV-positive tumors. HPV was associated with higher age (55.5 vs. 52.7 years, p = 0.004), lower T-stage (p = 0.008) better overall survival (OS) (hazard ratio [HR] 0.58 [95% CI 0.42-0.81], p = 0.001), and disease-free survival (DFS) (HR 0.54 [95% CI 0.40-0.73], p < 0.0001). Alcohol was strongly associated with recurrence and death (OS: HR 2.06 [95% CI 1.54-2.74], p < 0.0001; DFS: HR 1.72 [95% CI 1.33-2.24], p < 0.0001). OS and DFS in HPV-positive cases decreased for alcohol users (p < 0.0001). Obscured by the strong alcohol effect, predictive associations were not found for tobacco or betel quid. CONCLUSIONS As with HPV-positive OPSCC globally, HPV is an increasingly important etiological factor in Taiwanese OPSCC. HPV-positive OPSCC has considerable survival benefit, but this is reduced by alcohol, tobacco, and betel quid use. hrHPV is a cancer risk factor in males and females. Vaccinating both sexes with a multivalent vaccine including HPV58, combined with alcohol and tobacco cessation policies will be effective cancer-prevention public health strategies in Taiwan.
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Affiliation(s)
- Guadalupe Lorenzatti Hiles
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Kai-Ping Chang
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital (Linkou Medical Center), Taoyuan, Taiwan, Republic of China
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Emily L. Bellile
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Chun-I Wang
- Radiation Biology Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Wei-Chen Yen
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital (Linkou Medical Center), Taoyuan, Taiwan, Republic of China
| | - Christine M. Goudsmit
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Hannah L. Briggs
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Trey B. Thomas
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Lila Peters
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Macy A. Afsari
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Lisa M. Pinatti
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
- Cancer Biology Program, Rackham Graduate School, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Anna C. Morris
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Nadine Jawad
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Thomas E. Carey
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Heather M. Walline
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
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Bunch PM, Patwa HS, Hughes RT, Porosnicu M, Waltonen JD. Patient Selection for Transoral Robotic Surgery (TORS) in Oropharyngeal Squamous Cell Carcinoma: What the Surgeon Wants to Know. Top Magn Reson Imaging 2021; 30:117-130. [PMID: 33828063 DOI: 10.1097/rmr.0000000000000269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT Transoral robotic surgery (TORS) is an excellent treatment strategy for well-selected patients with oropharyngeal squamous cell carcinoma. Potential benefits of TORS are greatest among patients for whom surgical resection will reduce or eliminate the need for adjuvant therapy. Proper patient selection largely depends on imaging, which is used to determine tumor resectability, to inform expected morbidity and functional outcome, to assess the potential need for adjuvant therapy, to evaluate for vascular or other anatomic contraindications, and to gauge adequacy of transoral access to the tumor. This article provides the radiologist with a practical and accessible approach to interpreting preoperative imaging among patients with oropharyngeal cancer, emphasizing what the surgeon wants to know to inform the determination of whether the patient is a TORS candidate and why this information is important. By accurately reporting this information, the radiologist facilitates the multidisciplinary care team's selection of a treatment regimen optimized for the circumstances of the individual patient.
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Affiliation(s)
- Paul M Bunch
- Department of Radiology Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC
| | - Hafiz S Patwa
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Winston Salem, NC
| | - Ryan T Hughes
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston Salem, NC
| | - Mercedes Porosnicu
- Department of Hematology and Oncology, Wake Forest School of Medicine, Winston Salem, NC
| | - Joshua D Waltonen
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Winston Salem, NC
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Screening for irradiation vasculopathy by intima-media thickness sonography in head and neck cancer patients. Eur Arch Otorhinolaryngol 2020; 278:2017-2026. [PMID: 32870365 PMCID: PMC8131284 DOI: 10.1007/s00405-020-06301-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/15/2020] [Indexed: 11/26/2022]
Abstract
Purpose Post-irradiation vasculopathy is a severe form of atherosclerosis and affects the prognosis of head and neck cancer survivors. Sonographic intima-media thickness (IMT) precedes stenosis, plaque formation, and cerebrovascular events. Therefore, IMT may be a valuable screening marker for post-irradiation toxicity. However, the critical irradiation dose and the onset of IMT increase remain unclear. Methods The cross-sectional study analysed the carotid artery IMT in 96 irradiated patients and 41 controls regarding irradiation dose, post-irradiation-interval, and cardiovascular risk factors. Distinct irradiation doses to the tumour side and the contralateral hemineck enabled detection of dose depended effects within one patient and control of risk factors. Results Radiotherapy caused a dose-dependent increase in IMT. The toxicity did not have saturation effects for > 60 Gy. The IMT increase occurred in short-term following radiotherapy and the risk for a pathological value (> 0.9 mm) rose significantly. The correlation between IMT and radiotherapy was comparable to established cardiovascular risk factors. Conclusion Radiotherapists should consider the additional toxicity of high doses for non-metastatic head and neck cancer. If neck metastases require radiotherapy with boost, IMT measurement is suitable for early detection of carotid artery damage.
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Patel D, Haria S, Patel V. Oropharyngeal cancer and osteoradionecrosis in a novel radiation era: a single institution analysis. ACTA ACUST UNITED AC 2020. [DOI: 10.1111/ors.12546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D. Patel
- Department of Oral Surgery Stoke Mandeville Hospital Aylesbury UK
| | - S. Haria
- Fl 23 Oral Surgery Department Guy's & St Thomas' NHS Foundation Trust London UK
| | - V. Patel
- Fl 23 Oral Surgery Department Guy's & St Thomas' NHS Foundation Trust London UK
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11
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Patel V, Patel D, Browning T, Patel S, McGurk M, Sassoon I, Guerrero Urbano T, Fenlon M. Pre-radiotherapy dental status of oropharyngeal cancer patients based on HPV status in a novel radiation era. Br Dent J 2020:10.1038/s41415-020-1922-y. [PMID: 32801325 DOI: 10.1038/s41415-020-1922-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objectives Among common head and neck cancers (HNCs), oropharyngeal cancer (OPC) patients have been identified as having a better dentition than many other tumour subsites. OPC consists of human papillomavirus (HPV)-positive and negative groups with different prognosis. The purpose of this study is to explore the presenting dental status of OPC patients based on HPV status at the pre-radiotherapy phase.Materials and methods The study reviewed the dental panoramic radiographs of OPC patients seen at a dedicated pre-radiotherapy dental assessment clinic from 2011-2017. Only patients planned for intensity-modulated radiotherapy treatment were included within this study. Relevant dental and oncological data were collected.Results A total of 316 patients with known HPV status (215 positive; 101 negative) were included for analysis. HPV-positive patients had significantly more teeth on attendance than HPV-negative patients (22.3 vs 19.0, p = 0.0000) and horizontal bone loss was less severe compared to HPV-negative patients (p = 0.0000). HPV-positive males and patients in the 55-64 decade presented with the best and most complex dentition.Conclusion The rise of OPC with the prospect of long survival, particularly in HPV-positive patients, requires a dentition with adequate function and subsequent maintenance. The current study demonstrated that these patients have a complex dentition presenting new challenges to the dentist. This may explain in part the elevated osteoradionecrosis rate seen in this tumour group.
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Affiliation(s)
- Vinod Patel
- Guy's and St Thomas' NHS Foundation Trust, Department of Oral Surgery, Floor 23, Tower Wing, Great Maze Pond, London, SE1 9RT, UK.
| | - Dipesh Patel
- Guy's and St Thomas' NHS Foundation Trust, Department of Oral Surgery, Floor 23, Tower Wing, Great Maze Pond, London, SE1 9RT, UK
| | - Timothy Browning
- Guy's and St Thomas' NHS Foundation Trust, Department of Oral Surgery, Floor 23, Tower Wing, Great Maze Pond, London, SE1 9RT, UK
| | - Sheelen Patel
- Guy's and St Thomas' NHS Foundation Trust, Department of Oral Surgery, Floor 23, Tower Wing, Great Maze Pond, London, SE1 9RT, UK
| | - Mark McGurk
- Head and Neck Centre, UCL Division of Surgical Interventional Sciences, Head and Neck Unit, 250 Euston Road, London, NW1 2PG, UK
| | - Isabel Sassoon
- Computer Science Dept, Brunel University London, Kingston Lane, Uxbridge, Middlesex, WC2B 4LL, UK
| | | | - Michael Fenlon
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Floor 22, Guy's Hospital, London, SE1 9RT, UK
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12
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Early esophageal squamous cell carcinoma in a western series is not associated with active HPV infection. Virchows Arch 2020; 477:697-704. [PMID: 32524184 DOI: 10.1007/s00428-020-02860-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Abstract
Few data are available concerning human papillomavirus (HPV) in early esophageal squamous cell carcinoma (ESCC) in Western population. Our study intended to determine the prevalence of HPV infection and the histological characteristics in such early tumors. A monocentric and retrospective study was conducted including 86 patients with early ESCC treated by endoscopic resection or esophagectomy, from 2012 to 2018. Histopathological prognostic criteria were evaluated. Immunohistochemistry for p16 and p53 and an HPV mRNA in situ hybridization were performed. The tumors were composed of 25 (29%) in situ carcinomas, 21 (24%) intramucosal carcinomas, and 40 (47%) submucosal carcinomas, of which 34 had a deep infiltration (> 200 μm). Emboli, present in 12 cases, were associated with deep infiltration. P16-positive ESCC accounted for 21% of the patients. It was not correlated with active HPV infection as no cases were found to be positive in RISH analysis for RNA detection of this virus. However, there was a correlation between p16 expression and alcohol or tobacco consumption. The only histopathological criterion correlated with p16 positivity was marked inflammatory infiltrate. Local or distant neoplastic recurrence occurred in 25% of patients. Overall survival was 95.8% and local or metastatic recurrence-free survival was 75%. There was a correlation between positive resection margins and tumor recurrence. In contrast to oropharynx carcinoma, our study showed that ESCC were not associated with an active HPV infection, highlighting the negligible role of this virus in early ESCC carcinogenesis in the Western world.
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13
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Jank BJ, Kadletz L, Dunkler D, Haas M, Schnoell J, Kenner L, Heiduschka G. Epithelial stem cell marker LGR6 expression identifies a low-risk subgroup in human papillomavirus positive oropharyngeal squamous cell carcinoma. Oral Oncol 2020; 105:104657. [DOI: 10.1016/j.oraloncology.2020.104657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 03/08/2020] [Accepted: 03/16/2020] [Indexed: 01/07/2023]
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14
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van der Heijden M, Essers PBM, Verhagen CVM, Willems SM, Sanders J, de Roest RH, Vossen DM, Leemans CR, Verheij M, Brakenhoff RH, van den Brekel MWM, Vens C. Epithelial-to-mesenchymal transition is a prognostic marker for patient outcome in advanced stage HNSCC patients treated with chemoradiotherapy. Radiother Oncol 2020; 147:186-194. [PMID: 32413532 DOI: 10.1016/j.radonc.2020.05.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prognosis of patients with HPV-negative advanced stage head and neck squamous cell carcinoma (HNSCC) remains poor. No prognostic markers other than TNM staging are routinely used in clinic. Epithelial-to-mesenchymal transition (EMT) has been shown to be a strong prognostic factor in other cancer types. The purpose of this study was to determine the role of EMT in HPV-negative HNSCC outcomes. METHODS Pretreatment tumor material from patients of two cohorts, totalling 174 cisplatin-based chemoradiotherapy treated HPV-negative HNSCC patients, was RNA-sequenced. Seven different EMT gene expression signatures were used for EMT status classification and generation of HNSCC-specific EMT models using Random Forest machine learning. RESULTS Mesenchymal classification by all EMT signatures consistently enriched for poor prognosis patients in both cohorts of 98 and 76 patients. Uni- and multivariate analyses show important HR of 1.6-5.8, thereby revealing EMT's role in HNSCC outcome. Discordant classification by these signatures prompted the generation of an HNSCC-specific EMT profile based on the concordantly classified samples in the first cohort (cross-validation AUC > 0.98). The independent validation cohort confirmed the association of mesenchymal classification by the HNSCC-EMT model with poor overall survival (HR = 3.39, p < 0.005) and progression free survival (HR = 3.01, p < 0.005) in multivariate analysis with TNM. Analysis of an additional HNSCC cohort from PET-positive patients with metastatic disease prior to treatment further supports this relationship and reveals a strong link of EMT to the propensity to metastasize. CONCLUSIONS EMT in HPV-negative HNSCC co-defines patient outcome after chemoradiotherapy. The generated HNSCC-EMT prediction models can function as strong prognostic biomarkers.
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Affiliation(s)
- Martijn van der Heijden
- Division of Cell Biology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Paul B M Essers
- Division of Cell Biology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Caroline V M Verhagen
- Division of Cell Biology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, The Netherlands
| | - Joyce Sanders
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Reinout H de Roest
- Department of Otolaryngology/Head and Neck Surgery, VUmc Cancer Center Amsterdam, The Netherlands
| | - David M Vossen
- Division of Cell Biology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology/Head and Neck Surgery, VUmc Cancer Center Amsterdam, The Netherlands
| | - Marcel Verheij
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ruud H Brakenhoff
- Department of Otolaryngology/Head and Neck Surgery, VUmc Cancer Center Amsterdam, The Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Conchita Vens
- Division of Cell Biology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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15
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Ben Elhadj M, Fourati A, El Amine O, Goucha A, El May A, El May MV, Mokni Baizig N. Prevalence and Prognostic Value of HPV among Tunisian Patients with Laryngeal Cancer and Relationship between DNA HPV and p16, IGF-1R, Survivin, p53 Expressions. Ann Otol Rhinol Laryngol 2020; 129:863-871. [PMID: 32364419 DOI: 10.1177/0003489420918280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Tobacco and alcohol are the main etiological factors common to laryngeal cancers. However, the Human Papilloma Virus (HPV) constitutes an alternative risk factor according to several studies. In Tunisia, despite the annual increasing incidence of laryngeal squamous cell carcinoma (LSCC), the prevalence and prognostic significance of HPV have never been explored.In this study, we sought to highlight HPV DNA in 70 biopsies of laryngeal cancer, and to analyze the status of HPV infection in association with p53, p16, survivin, and IGF-1R expressions. METHODS HPV high risk (HPV HR) DNA was detected in tumors by in situ hybridization. However, the expression of p53, p16, survivin and IGF-1R were stained by immunohistochemistry test. The correlations of HPV status with clinicopathological parameters, overall survival, disease-free survival and proteins expressions were statistically evaluated. RESULTS HPV HR DNA was detected in 39 out of 70 (55.71%) laryngeal tumors. HPV+ patients have a better overall survival (P = .081) and long disease-free-survival (P = .016) with a low rate of recurrence (P = .006) than HPV- patients. No significant correlations were found between HPV HR status and clinicopathological parameters (all P > .005). Moreover, HPV+ tumors were not associated with expression of p53, p16 and survivin. However, HPV HR status correlates with weak to moderate IGF-1R expression (P = .043). CONCLUSION The substantial detection of HPV HR in LSCC tumors suggest that this virus plays an important part in laryngeal cancer in Tunisia. It is a good prognostic factor. In addition, HPV infection could act to block the pathway of IGF-1R expression.
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Affiliation(s)
- Mariem Ben Elhadj
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Asma Fourati
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Olfa El Amine
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Aida Goucha
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Ahmed El May
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Michèle-Veronique El May
- Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Nehla Mokni Baizig
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
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16
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Gal TJ, O'Brien KJ, Chen Q, Huang B. Clinical vs Microscopic Extranodal Extension and Survival in Oropharyngeal Carcinoma in the Human Papillomavirus Era. Otolaryngol Head Neck Surg 2020; 162:693-701. [PMID: 32151208 DOI: 10.1177/0194599820910431] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Extranodal extension (ENE) is known to be associated with poor outcomes in head and neck squamous cell carcinoma. The objective of this study is to examine the impact of extent of ENE on survival in oropharyngeal carcinoma in the human papillomavirus (HPV) era. STUDY DESIGN Retrospective database review. SETTING Review of the National Cancer Database. SUBJECTS AND METHODS The National Cancer Database was used to examine surgically treated head and neck squamous cell carcinoma of the tonsil and base of tongue from 2010 to 2015. Nodes available for pathologic examination were classified as ENE negative (-), ENE clinically (+), or ENE (+) on pathology only. The primary outcome was overall survival. Cox regression modeling was used to examine the effect of ENE on survival while controlling for patient demographics, HPV status, stage, adjuvant radiation, and chemotherapy. RESULTS Of the 66,106 patients identified, 16,845 were treated with surgery ± adjuvant therapy, 8780 of whom were known HPV+. Overall 5-year survival for this group was 86%. Documented ENE was associated with over a 60% decrease in survival for clinical (hazard ratio [HR], 1.63) and pathologic (HR, 1.62) ENE compared to negative ENE, after adjustment for stage, adjuvant radiation ± chemotherapy, HPV, and other variables. No significant differences were found between clinical and pathologic ENE (HR, 1.001). CONCLUSION While both surgically resected clinical and pathologic ENE are associated with decreased survival, no significant differences are observed between the two. The impact of these observations on potential de-escalation therapeutic strategies requires further study.
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Affiliation(s)
- Thomas J Gal
- Department of Otolaryngology, University of Kentucky, Lexington, Kentucky, USA
| | | | - Quan Chen
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Bin Huang
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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17
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Molecular Diagnostics in Human Papillomavirus-Related Head and Neck Squamous Cell Carcinoma. Cells 2020; 9:cells9020500. [PMID: 32098320 PMCID: PMC7072739 DOI: 10.3390/cells9020500] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/13/2020] [Accepted: 02/21/2020] [Indexed: 02/07/2023] Open
Abstract
The incidence of human papillomavirus (HPV)-related head and neck squamous cell carcinoma continues to increase. Accurate diagnosis of the HPV status of a tumor is vital, as HPV+ versus HPV- tumors represent two unique biological and clinical entities with different treatment strategies. High-risk HPV subtypes encode oncoproteins E6 and E7 that disrupt cellular senescence and ultimately drive tumorigenesis. Current methods for detection of HPV take advantage of this established oncogenic pathway and detect HPV at various biological stages. This review article provides an overview of the existing technologies employed for the detection of HPV and their current or potential future role in management and prognostication.
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18
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Roden DF, Hobelmann K, Vimawala S, Richa T, Fundakowski CE, Goldman R, Luginbuhl A, Curry JM, Cognetti DM. Evaluating the impact of smoking on disease‐specific survival outcomes in patients with human papillomavirus–associated oropharyngeal cancer treated with transoral robotic surgery. Cancer 2020; 126:1873-1887. [DOI: 10.1002/cncr.32739] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/05/2020] [Accepted: 01/14/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Dylan F. Roden
- Department of Otolaryngology–Head and Neck Surgery Rutgers University Newark New Jersey
| | - Kealan Hobelmann
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - Swar Vimawala
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - Tony Richa
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - Christopher E. Fundakowski
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - Richard Goldman
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - Adam Luginbuhl
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - Joseph M. Curry
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
| | - David M. Cognetti
- Department of Otolaryngology–Head and Neck Surgery Thomas Jefferson University Philadelphia Pennsylvania
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19
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Ramesh PS, Devegowda D, Singh A, Thimmulappa RK. NRF2, p53, and p16: Predictive biomarkers to stratify human papillomavirus associated head and neck cancer patients for de-escalation of cancer therapy. Crit Rev Oncol Hematol 2020; 148:102885. [PMID: 32062315 DOI: 10.1016/j.critrevonc.2020.102885] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/09/2020] [Accepted: 01/25/2020] [Indexed: 01/18/2023] Open
Abstract
Patients with HPV associated (HPV+ve) head and neck squamous cell carcinoma (HNSCC), particularly oropharyngeal cancer, show better treatment response, higher survival rates, and lower risks of recurrence as compared to HPV-ve HNSCC patients. Despite increased sensitivity to treatment modality, HPV+ve HNSCC patients are subjected to the same intensive anti-cancer therapy as HPV-ve HNSCC patients and thus subjecting them to unwarranted long-term toxicity. To identify predictive biomarkers for risk-stratification, we have analyzed the mutational spectrum, and the evidence suggests that gain-of-function mutations in the NRF2 pathway are highly prevalent in HPV-ve HNSCC. At the same time, it is rare in HPV+ve HNSCC tumors. We have reviewed the importance of gain-of-NRF2 function and loss of p53 in the prognosis of HNSCC patients and discussed a predictive scoring system using a combination of HPV status (p16), NRF2 pathway and p53 to stratify HPV+ve HNSCC into good versus poor responders, which could immensely help in guiding future de-escalation treatment approaches in patients with HPV+ve HNSCC.
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Affiliation(s)
- Pushkal S Ramesh
- Centre of Excellence in Molecular Biology & Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, India
| | - Devananda Devegowda
- Centre of Excellence in Molecular Biology & Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, India
| | - Anju Singh
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, United States
| | - Rajesh K Thimmulappa
- Centre of Excellence in Molecular Biology & Regenerative Medicine, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, India.
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20
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Rahimi S, Akaev I, Brennan PA, Virgo A, Marani C, Gomez RS, Yeoh CC. A proposal for classification of oropharyngeal squamous cell carcinoma: Morphology and status of HPV by immunohistochemistry and molecular biology. J Oral Pathol Med 2019; 49:110-116. [PMID: 31465605 DOI: 10.1111/jop.12956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The current three-tier grading system (well, moderate and poorly differentiated) used to morphologically classify head and neck squamous cell carcinoma (HNSCC) is inadequate for categorisation of oropharyngeal squamous cell carcinoma (OPSCC) owing to the lack of prognostic value. The aim of this study was to assess the validity of a classification system for OPSCC based on morphology and human papilloma virus (HPV) infection status. Haematoxylin and eosin slides of 121 patients (100 M, 21 F, age range 40-89 years) with OPSCC were reviewed and categorised as histological types I, II and III. The presence of HPV was assessed by immunohistochemistry with p16 and RNAscope In situ hybridization (ISH). The follow-up period was 36 months. Ninety-six patients were p16+ and clinical stage I. Patient survival with types I, II and III was 93%, 50% and 96%, respectively. Twenty-five patients were p16-: 10 clinical stage I and 15 stage III. Amongst this group, no type I morphology was identified. At follow-up, 65% of type II and 75% of type III patients were alive. All p16+ cases were also positive for E6/E7 mRNA high-risk HPV by ISH, while 23 p16- cases were negative and two were positive. Cox regression identified three predictors of mortality: older age (HR = 1.14, 95% CI = 1.06-1.23, P = .001); female gender (HR = 0.22.95% CI 0.05-0.88, P = .033); and type II morphology (HR = 13.1, 95% CI = 1.09-157.0, P = .043). OPSCC morphological classification in three sub-types, along with HPV infection status, seems to reflect the outcome of patients with OPSCC.
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Affiliation(s)
- Siavash Rahimi
- Frontier Pathology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Iolia Akaev
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| | - Azarel Virgo
- Department of Oncology, Queen Alexandra Hospital, Portsmouth, UK
| | - Carla Marani
- Histopathology Division, San Carlo di Nancy Hospital, Rome, Italy
| | - Ricardo S Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Chit Cheng Yeoh
- Department of Oncology, Queen Alexandra Hospital, Portsmouth, UK
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21
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Yang Z, Gomez‐Fernandez C, Lora Gonzalez M, Esebua M, Kerr DA. HPV testing through p16 immunocytochemistry in neck‐mass FNA and its correlation with tissue samples. Cancer Cytopathol 2019; 127:458-464. [DOI: 10.1002/cncy.22156] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Zhongbo Yang
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
| | - Carmen Gomez‐Fernandez
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
| | - Manuel Lora Gonzalez
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
| | - Magda Esebua
- Department of Pathology University of Missouri Columbia Missouri
| | - Darcy A. Kerr
- Department of Pathology University of Miami Hospital/Jackson Memorial Hospital Miami Florida
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22
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Leonard BC, Lee ED, Bhola NE, Li H, Sogaard KK, Bakkenist CJ, Grandis JR, Johnson DE. ATR inhibition sensitizes HPV - and HPV + head and neck squamous cell carcinoma to cisplatin. Oral Oncol 2019; 95:35-42. [PMID: 31345392 DOI: 10.1016/j.oraloncology.2019.05.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/21/2019] [Accepted: 05/29/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Cisplatin is commonly used in the treatment of head and neck squamous cell carcinoma (HNSCC), and the repair of cisplatin-induced DNA damage involves activation of the DNA damage response protein ataxia telangiectasia and Rad3-related (ATR). Resistance to cisplatin therapy exacerbates adverse toxicities and is associated with poor outcomes. Since repair of cisplatin-induced DNA damage contributes to resistance, we hypothesized that inhibition of ATR using AZD6738, a well-tolerated and orally-bioavailable inhibitor, would enhance the sensitivity of HNSCC cells and tumors to cisplatin. MATERIALS AND METHODS A panel of human papilloma virus-negative (HPV-) and HPV+ HNSCC cell lines were treated with cisplatin in the absence or presence of AZD6738, and effects on cell viability, colony formation, apoptosis signaling, and DNA damage were assessed. The impact of co-treatment with cisplatin plus AZD6738 on the growth of HPV- and HPV+ cell line- and patient-derived xenograft tumors was also examined. RESULTS Inhibition of ATR with AZD6738 enhanced cisplatin-induced growth inhibition of HNSCC cell lines and tumors, in association with increased apoptosis signaling and DNA damage. Both HPV- and HPV+ models were sensitized to cisplatin by ATR inhibition. CONCLUSION Inhibition of ATR promotes sensitization to cisplatin in preclinical in vitro and in vivo models of HPV- and HVP+ HNSCC, supporting clinical evaluation of this strategy in this disease.
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Affiliation(s)
- Brandon C Leonard
- Department of Otolaryngology, University of California, San Francisco, CA, USA
| | - Eliot D Lee
- Department of Otolaryngology, University of California, San Francisco, CA, USA
| | - Neil E Bhola
- Department of Otolaryngology, University of California, San Francisco, CA, USA
| | - Hua Li
- Department of Otolaryngology, University of California, San Francisco, CA, USA
| | - Kristian K Sogaard
- Department of Otolaryngology, University of California, San Francisco, CA, USA
| | - Christopher J Bakkenist
- Departments of Radiation Oncology and Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer R Grandis
- Department of Otolaryngology, University of California, San Francisco, CA, USA
| | - Daniel E Johnson
- Department of Otolaryngology, University of California, San Francisco, CA, USA.
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23
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Hong AM, Ferguson P, Dodds T, Jones D, Li M, Yang J, Scolyer RA. Significant association of PD-L1 expression with human papillomavirus positivity and its prognostic impact in oropharyngeal cancer. Oral Oncol 2019; 92:33-39. [DOI: 10.1016/j.oraloncology.2019.03.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 03/04/2019] [Accepted: 03/13/2019] [Indexed: 12/25/2022]
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24
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Human papillomavirus 16 and p16 positive nasal cutaneous squamous cell carcinoma in immunocompetent men in their twenties. The Journal of Laryngology & Otology 2019; 133:348-352. [PMID: 30967163 DOI: 10.1017/s0022215119000641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma is usually associated with long-term ultraviolet light exposure. Human papillomavirus 16 is a high-risk mucosal human papillomavirus type, usually associated with anogenital and oropharyngeal cancer. This paper describes the first two cases of human papillomavirus 16 and p16 related nasal cutaneous squamous cell carcinoma. METHOD Prospective case series from December 2015. RESULTS Two young, male, fair-skinned patients had large (greater than 20 mm), rapidly growing, ulcerated lesions of the nasal tip. The tumours were excised, with at least a 6 mm margin, and the patients' noses were subsequently reconstructed. Neither patient had cervical lymphadenopathy or underwent adjuvant radiotherapy. Both patients were registered at the same general practice. The tumours were human papillomavirus 16 and p16 positive; the latter indicated that the virus was driving the disease process. Except for superficial burns, neither patient had other risk factors. CONCLUSION Changes in sexual practices have led to an increase in human papillomavirus positive oropharyngeal carcinoma and there may be an associated increase in human papillomavirus type 16 positive nasal cutaneous squamous cell carcinoma.
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Götz C, Bischof C, Wolff KD, Kolk A. Detection of HPV infection in head and neck cancers: Promise and pitfalls in the last ten years: A meta-analysis. Mol Clin Oncol 2019; 10:17-28. [PMID: 30655973 PMCID: PMC6313947 DOI: 10.3892/mco.2018.1749] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
The current controversial discussion on the disease-specific survival of patients with human papillomavirus (HPV)-positive (+) and -negative (-) squamous cell carcinoma (SCC) of the head neck region was the motivation for the present meta-analysis. Different detection methods for HPV are available, though these often lack sensitivity. As a consequence, there may be false interpretation of HPV positivity. A bias concerning HPV status and therefore also survival rates is serving a non-durable relevance in the discussion of tailored therapies. A literature search was performed via the online database PubMed/NCBI, and data extraction and statistical analysis were conducted. A total of 139 studies published between 2004 and 2014 were evaluated in the present meta-analysis. The HPV detection methods, patient characteristics, tumor localizations and stages, as well as (neo-) adjuvant therapies and survival times were analyzed. The average incidence rates of HPV+ patients with oropharyngeal tumors were higher than those of patients with cancers of other regions of the head and neck. Upon evaluating the results of different detection methods no significant differences were identified. We have compared the HPV incidence rates of each detection method, when studies have used more than one. Regarding overall survival, the pooled adjusted hazard ratio (HR) for oropharyngeal SCC was 0.31 [95% confidence interval (CI)=0.27-0.36]. Unfortunately, only 3 equivalent studies were available on nonoropharyngeal tumors, for which the pooled adjusted HR was 1 (95% CI=0.73-1.36). Overall, the evaluation demonstrated that the survival rates reported in numerous studies were not evaluated multifactorially and important confounders were excluded from the statistics. The HPV detection methods used were often not sufficient in representing HPV positivity. In addition, oropharyngeal and oral SCCs were assessed together in the localization. The widely differing number of HPV+ patients in each of the various studies may be explained by insufficient detection methods and by a lack of localization distinction. The considerations of a tailored therapy according to HPV status should be rejected based on the present information. The previously published studies should be read critically and do not represent a basis for therapeutic decisions.
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Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Clara Bischof
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
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Montero PH. Cáncer de Cabeza y Cuello asociado a Virus Papiloma Humano: Prevención, diagnóstico y tratamiento. REVISTA MÉDICA CLÍNICA LAS CONDES 2018. [DOI: 10.1016/j.rmclc.2018.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Human papillomavirus 16 E6 modulates the expression of miR-496 in oropharyngeal cancer. Virology 2018; 521:149-157. [PMID: 29935424 DOI: 10.1016/j.virol.2018.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 11/24/2022]
Abstract
Human papillomavirus (HPV), notably type 16, is a risk factor for up to 75% of oropharyngeal squamous cell carcinomas (SCC). It has been demonstrated that small non-coding RNAs known as microRNAs play a vital role in the cellular transformation process. In this study, we used an LNA array to further investigate the impact of HPV16 on the expression of microRNAs in oropharyngeal (tonsillar) cancer. A number of miRNAs were found to be deregulated, with miR-496 showing a four-fold decrease. Over-expression of the high risk E6 oncoprotein down-regulated miR-496, impacting upon the post-transcriptional control of the transcription factor E2F2. These HPV specific miRNAs were integrated with the HPV16 interactome to identify possible mechanistic pathways. These analyses provide insights into novel molecular interactions between HPV16 and miRNAs in oropharyngeal cancers.
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Ahmadi N, Chan M, Huo YR, Sritharan N, Chin RY. Survival outcome of tonsillar squamous cell carcinoma (TSCC) in the context of human papillomavirus (HPV): A systematic review and meta-analysis. Surgeon 2018; 17:6-14. [PMID: 29843958 DOI: 10.1016/j.surge.2018.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 04/23/2018] [Accepted: 04/28/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The objective of our study was to assess whether HPV-positive TSCC had better survival and prognosis rates, when compared to HPV-negative TSCC. METHOD A systematic review and meta-analysis was performed comparing HPV status in TSCC patients. TSCC was confirmed with histopathology and HPV status was confirmed with PCR, immunohistochemistry and/or in-situ-hybridisation. The primary endpoints were overall survival (OS) and disease free survival (DFS). RESULTS Twenty-four studies were identified, involving 1921 TSCC cases, of which 56.2% (1079) were HPV positive. OS was significantly higher in patients with HPV-positive compared to HPV-negative TSCC in years 1-5 (OR 2.54, P < 0.01; OR 2.93 P < 0.01; OR 2.74 P < 0.01; OR 2.20 P < 0.01, and OR 2.14 P < 0.01 respectively). Similarly, DFS was also significantly higher in patients with HPV-positive compared to HPV-negative TSCC in years 1-3 (OR 2.86, P < 0.01; OR 2.60 P < 0.02; and OR 2.60 P < 0.01 respectively), which was attenuated in years 4 and 5 (OR 1.83, P = 0.10 and OR 1.50, P = 0.12). CONCLUSION This is the largest meta-analysis with 1921 patients, comparing non-HPV induced TSCC and HPV induced TSCC, looking at outcome and survival. HPV-positive had better OS and DFS.
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Affiliation(s)
- Navid Ahmadi
- Department of Otolaryngology and Head and Neck Surgery, Nepean Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - Michael Chan
- Department of Radiology, Concord Repatriation General Hospital, Sydney, NSW, Australia; University of New South Wales, Sydney, NSW, Australia
| | - Ya Ruth Huo
- University of New South Wales, Sydney, NSW, Australia
| | - Niranjan Sritharan
- Department of Otolaryngology and Head and Neck Surgery, Nepean Hospital, Sydney, NSW, Australia; Western Sydney University, Sydney, NSW, Australia
| | - Ronald Y Chin
- Department of Otolaryngology and Head and Neck Surgery, Nepean Hospital, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia.
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Virtanen E, Laurila P, Hagström J, Nieminen P, Auvinen E. Testing for high-risk HPV in cervical and tonsillar paraffin-embedded tissue using a cartridge-based assay. APMIS 2017; 125:910-915. [PMID: 28736821 DOI: 10.1111/apm.12727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
Abstract
This study evaluates the suitability of Xpert HPV (Cepheid, Sunnyvale, CA, USA) test for cervical and tonsillar formalin-fixed paraffin-embedded (FFPE) tissue samples as compared to the tests currently used in diagnostics. Cervical biopsies and liquid cytology (LC) samples were collected from 48 women attending colposcopy. Biopsies were processed for histology and tested for hrHPV using Xpert HPV. LC samples were tested using Xpert and Hybrid Capture 2 (HC2; Qiagen, Hilden, Germany) tests. Also 29 archived tonsillar carcinoma samples were tested using Xpert, and the results were compared with histology and immunohistochemical p16INK4a (p16) staining. Among valid cervical LC samples 46.8% were hrHPV positive using Xpert test and 55.3% with HC2. The sensitivity of Xpert was 84.6% as compared to HC2, and overall test concordance was 91.5%. Test concordance between valid Xpert results from biopsies and LC samples was 84.6%. Among valid tonsillar samples 70.4% were hrHPV positive, and concordance of 96.3% was found between Xpert and p16 staining. To conclude, Xpert HPV test cartridge provides a convenient platform to test individual samples, including FFPE samples. Further studies are needed to establish whether test sensitivity is sufficient to reliably differentiate between hrHPV positive and hrHPV negative head and neck carcinomas.
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Affiliation(s)
- Elina Virtanen
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pekka Laurila
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pekka Nieminen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eeva Auvinen
- Department of Virology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Liu H, Li J, Zhou Y, Hu Q, Zeng Y, Mohammadreza MM. Human papillomavirus as a favorable prognostic factor in a subset of head and neck squamous cell carcinomas: A meta-analysis. J Med Virol 2016; 89:710-725. [PMID: 27575972 DOI: 10.1002/jmv.24670] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 08/22/2016] [Accepted: 08/27/2016] [Indexed: 12/24/2022]
Abstract
Many epidemical and biological studies have proposed that human papillomavirus (HPV), primarily high-risk HPV16/18, is an etiological factor for a subset of head and neck (HN) cancers. On that premise, we systematically reviewed relevant articles and improved the understanding of HPV-related cancers. This article comprehensively described the characteristics of HPV-associated HN tumors according to demography, histopathology, molecular biology, and prognosis. Meta-analyses were conducted to combine the studies that reported the association between HPV status and these variables using Rev Man 5.0. The pooled results showed that HPV-positive tumors were not only poorly differentiated (OR = 2.77, 95% CI: 2.3-3.32) and smaller (OR = 2.21, 95% CI: 1.75-2.8) but were also strongly associated with oropharynx (OR = 5.8, 95% CI: 4.01-8.38) and node involvement (OR = 2.77, 95% CI: 2.3-3.32). HPV-related tumors showed significantly more p16 overexpression (OR = 34.55, 95% CI: 20.91-57.09) and less TP53 mutations (OR = 0.27, 95% CI: 0.18-0.41) than HPV-negative tumors. The patients with HPV-positive cancers had different clinical behaviors, such as a reduced risks of death (HR = 0.32, 95% CI: 0.29-0.36). This study supported the view point that HPV is a favorable indicator of prognosis and that HPV-related HN tumors are distinct from traditional tumors. This etiological relationship could impact future strategies of diagnosis, prevention, therapy, and prognosis for this subset of patients. J. Med. Virol. 89:710-725, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hongwei Liu
- Center for Stem Cell Research and Application, Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Chengdu, China.,Beijing Key Laboratory of Environmental and Viral Oncology, College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing, China
| | - Jintao Li
- Beijing Key Laboratory of Environmental and Viral Oncology, College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing, China.,Hubei Key Laboratory of Medical Information Analysis & Tumor Diagnosis and Treatment, Hubei, China
| | - Yubai Zhou
- Beijing Key Laboratory of Environmental and Viral Oncology, College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing, China
| | - Qin Hu
- Beijing Key Laboratory of Environmental and Viral Oncology, College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing, China
| | - Yi Zeng
- Beijing Key Laboratory of Environmental and Viral Oncology, College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing, China.,National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, and State Key Laboratory for Infectious Disease Prevention and Control, Beijing, China
| | - Mohammadzad Mehryar Mohammadreza
- Beijing Key Laboratory of Environmental and Viral Oncology, College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing, China.,Hubei Key Laboratory of Medical Information Analysis & Tumor Diagnosis and Treatment, Hubei, China
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Michmerhuizen NL, Birkeland AC, Bradford CR, Brenner JC. Genetic determinants in head and neck squamous cell carcinoma and their influence on global personalized medicine. Genes Cancer 2016; 7:182-200. [PMID: 27551333 PMCID: PMC4979591 DOI: 10.18632/genesandcancer.110] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
While sequencing studies have provided an improved understanding of the genetic landscape of head and neck squamous cell carcinomas (HNSCC), there remains a significant lack of genetic data derived from non-Caucasian cohorts. Additionally, there is wide variation in HNSCC incidence and mortality worldwide both between and within various geographic regions. These epidemiologic differences are in part accounted for by varying exposure to environmental risk factors such as tobacco, alcohol, high risk human papilloma viruses and betel quid. However, inherent genetic factors may also play an important role in this variability. As limited sequencing data is available for many populations, the involvement of unique genetic factors in HNSCC pathogenesis from epidemiologically diverse groups is unknown. Here, we review current knowledge about the epidemiologic, environmental, and genetic variation in HNSCC cohorts globally and discuss future studies necessary to further our understanding of these differences. Long-term, a more complete understanding of the genetic drivers found in diverse HNSCC cohorts may help the development of personalized medicine protocols for patients with rare or complex genetic events.
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Affiliation(s)
- Nicole L Michmerhuizen
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrew C Birkeland
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Carol R Bradford
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J Chad Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
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Sznurkowski JJ, Żawrocki A, Biernat W. The overexpression of p16 is not a surrogate marker for high-risk human papilloma virus genotypes and predicts clinical outcomes for vulvar cancer. BMC Cancer 2016; 16:465. [PMID: 27411473 PMCID: PMC4944532 DOI: 10.1186/s12885-016-2503-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/05/2016] [Indexed: 02/04/2023] Open
Abstract
Background We aimed to evaluate the correlation between p16ink4a-overexpression and high risk (hr)HPV-DNA in vulvar squamous cell carcinoma (vSCC) tumors as well as the impact of both biomarkers on the prognosis of vSCC patients. Methods PCR-detection of (hr)HPV-DNA and immunohistochemical staining for p16ink4a were conducted in 85 vSCC tumors. Survival analyses included the Kaplan–Meier method, log-rank test and Cox proportional hazards model. Results p16ink4a-overexpression and (hr)HPV-DNA were detected in 35 and 37 of the 85 tumors, respectively. Among the 35 p16ink4a-positive tumors, 10 lacked (hr)HPV-DNA (29 %). Among the 50 p16ink4a-negative tumors, (hr)HPV-DNA was detected in 12 cases (24 %). The median follow-up was 89.20 months (range 1.7–189.5 months). P16ink4a-overexpression, but not (hr)HPV-DNA positivity of the primary tumor, was correlated with prolonged overall survival (OS) (p = 0.009). P16ink4a-overexpression predicted a better response to radiotherapy (p < 0.001). Univariate analysis has demonstrated that age (p = 0.025), tumor grade (p = 0.001), lymph node metastasis (p < 0.001), FIGO stage (p < 0.001), p16ink4a-overexpression (p = 0.022), and adjuvant RTX (p < 0.001) were prognostic factors for OS. Multivariate analysis has demonstrated that lymph node metastasis (HR 1–2.74, 95 % CI 1.50–5.02, p = 0.019), tumor grade (HR 1–2.80, 95 % CI 1.33–5.90, p = 0.007) and p16ink4a-overexpression (HR 1–2.11, 95 % CI 1.13–3.95, p = 0.001) are independent prognostic factors. Conclusion The discovered overlap suggests the use of p16ink4a in combination with HPV-DNA detection as an ancillary test for future research and clinical studies in vSCC. The prognostic and predictive value of p16ink4a-overexpression should be tested in larger cohort studies. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2503-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jacek J Sznurkowski
- Department of Surgical Oncology, The Medical University of Gdańsk, ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland.
| | - Anton Żawrocki
- Department of Pathology, The Medical University of Gdańsk, ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | - Wojciech Biernat
- Department of Pathology, The Medical University of Gdańsk, ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland
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Abstract
We examined p16 expression in tumors from a population-based sample of laryngeal cancer cases diagnosed in the U.S. Samples had been previously genotyped for HPV DNA. Overall, p16 expression was observed in laryngeal tissue from 8 of 101 (7.9%) cases. p16 expression was observed in 2 of 16 (12.5%) cases previously determined to be HPV DNA positive. The two cases dually positive for p16 and HPV DNA were non-keratinizing SCC and papillary SCC tumors that were positive for genotypes 18 and 35/89, respectively. Positivity for p16 and/or HPV DNA was not associated with 5-year survival (log-rank p value=0.55). Our findings support a limited role of HPV in laryngeal carcinogenesis. p16 is not a reliable surrogate for HPV status in laryngeal cancers and is not a predictor of laryngeal cancer survival.
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Zhang X, Gee H, Rose B, Lee CS, Clark J, Elliott M, Gamble JR, Cairns MJ, Harris A, Khoury S, Tran N. Regulation of the tumour suppressor PDCD4 by miR-499 and miR-21 in oropharyngeal cancers. BMC Cancer 2016; 16:86. [PMID: 26867589 PMCID: PMC4750294 DOI: 10.1186/s12885-016-2109-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 02/02/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The rates of oropharyngeal cancers such as tonsil cancers are increasing. The tumour suppressor protein Programmed Cell Death Protein 4 (PDCD4) has been implicated in the development of various human cancers and small RNAs such as microRNAs (miRNAs) can regulate its expression. However the exact regulation of PDCD4 by multiple miRNAs in oropharyngeal squamous cell carcinoma (SCC) is not well understood. RESULTS Using two independent oropharyngeal SCC cohorts with a focus on the tonsillar region, we identified a miRNA profile differentiating SCC tissue from normal. Both miR-21 and miR-499 were highly expressed in tonsil SCC tissues displaying a loss of PDCD4. Interestingly, expression of the miRNA machinery, Dicer1, Drosha, DDX5 (Dead Box Helicase 5) and DGCR8 (DiGeorge Syndrome Critical Region Gene 8) were all elevated by greater than 2 fold in the tonsil SCC tissue. The 3'UTR of PDCD4 contains three binding-sites for miR-499 and one for miR-21. Using a wild-type and truncated 3'UTR of PDCD4, we demonstrated that the initial suppression of PDCD4 was mediated by miR-21 whilst sustained suppression was mediated by miR-499. Moreover the single miR-21 site was able to elicit the same magnitude of suppression as the three miR-499 sites. CONCLUSION This study describes the regulation of PDCD4 specifically in tonsil SCC by miR-499 and miR-21 and has documented the loss of PDCD4 in tonsil SCCs. These findings highlight the complex interplay between miRNAs and tumour suppressor gene regulation and suggest that PDCD4 loss may be an important step in tonsillar carcinogenesis.
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Affiliation(s)
- Xiaoying Zhang
- The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
- Department of Infectious Diseases and Immunology, University of Sydney, Sydney, NSW, Australia
| | - Harriet Gee
- Cancer Research UK Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, OX3 9DS, UK
- Central Clinical School, University of Sydney, NSW, Australia
| | - Barbara Rose
- The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
- Department of Infectious Diseases and Immunology, University of Sydney, Sydney, NSW, Australia
| | - C Soon Lee
- Discipline of Pathology, School of Medicine, University of Western Sydney and Cancer Pathology, Bosch Institute, University of Sydney, Sydney, Australia
| | - Jonathan Clark
- The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
- Central Clinical School, University of Sydney, NSW, Australia
- South Western Clinical School, University of NSW, Sydney, Australia
| | - Michael Elliott
- The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia
- Central Clinical School, University of Sydney, NSW, Australia
| | - Jennifer R Gamble
- Centre for the Endothelium, Vascular Biology Program, Centenary Institute, Sydney, Australia
| | - Murray J Cairns
- Schizophrenia Research Institute, Sydney, NSW, Australia
- School of Biomedical Sciences, Faculty of Health, and Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia
| | - Adrian Harris
- Cancer Research UK Molecular Oncology Laboratories, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, OX3 9DS, UK
| | - Samantha Khoury
- Centre of Health Technologies. Faculty of Engineering and Information Technology, University of Technology, NSW, Australia
| | - Nham Tran
- The Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.
- Centre of Health Technologies. Faculty of Engineering and Information Technology, University of Technology, NSW, Australia.
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Sedghizadeh PP, Billington WD, Paxton D, Ebeed R, Mahabady S, Clark GT, Enciso R. Is p16-positive oropharyngeal squamous cell carcinoma associated with favorable prognosis? A systematic review and meta-analysis. Oral Oncol 2016; 54:15-27. [PMID: 26794879 DOI: 10.1016/j.oraloncology.2016.01.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/30/2015] [Accepted: 01/01/2016] [Indexed: 12/29/2022]
Abstract
The purpose of this systematic review and meta-analysis was to compare the prognosis of patients with p16 expressing oropharyngeal squamous cell cancers to patients with p16 non-expressing cancers. Clinical outcomes that were evaluated included overall survival, local recurrence, disease-free survival, disease-specific survival, and event-free survival. The following electronic databases were searched: Cochrane Library, MEDLINE (via Pubmed), and Web of Science. Publications were restricted to English language. Studies were limited to controlled clinical trials on the survival rates of patients with oropharyngeal tumors that were p16 expressing, compared to patients with p16 non-expressing tumors, and at least one clinical endpoint reported by trial authors (hazard ratios). Specific ascertainment criteria were applied for inclusion and exclusion of eligible studies. Data was independently extracted in duplicate. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA checklist. Risk of bias was assessed for all included studies, and disagreements between review authors were discussed until an agreement was reached. Eighteen studies were included for final review and meta-analysis. The subgroup meta-analyses, which included survival and recurrence data, showed significantly favorable outcomes for patients with p16 expressing tumors. There is strong evidence to support that patients with p16 expressing oropharyngeal squamous cell cancers have favorable clinical outcomes and prognosis.
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Affiliation(s)
- Parish P Sedghizadeh
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
| | - William D Billington
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Dain Paxton
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Rabeh Ebeed
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Susan Mahabady
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Glenn T Clark
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Reyes Enciso
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
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Boscolo-Rizzo P, Pawlita M, Holzinger D. From HPV-positive towards HPV-driven oropharyngeal squamous cell carcinomas. Cancer Treat Rev 2016; 42:24-9. [DOI: 10.1016/j.ctrv.2015.10.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 10/22/2015] [Indexed: 11/15/2022]
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37
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Lam EWH, Chan JYW, Chan ABW, Ng CS, Lo STH, Lam VSC, Chan MMH, Ngai CM, Vlantis AC, Ma RKH, Chan PKS. Prevalence, Clinicopathological Characteristics, and Outcome of Human Papillomavirus-Associated Oropharyngeal Cancer in Southern Chinese Patients. Cancer Epidemiol Biomarkers Prev 2015; 25:165-73. [PMID: 26604268 DOI: 10.1158/1055-9965.epi-15-0869] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/08/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although the global incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasing, there is little information on southern Chinese population available. METHODS We analyzed 207 patients which constituted 63.5% of all newly diagnosed OPSCC in Hong Kong during a 5-year period from 2005 to 2009. RESULTS We used E6/7 mRNA as a marker of oncogenic involvement and found 20.8% (43/207) of OPSCC and 29.0% (36/124) of tonsillar SCC was associated with HPV. HPV-16 was identified in all cases except one (HPV-18). Patients with HPV-associated OPSCCs were significantly younger than HPV-negative patients (mean age: 59.8 vs. 63.9 years, P = 0.05). Multivariate analysis showed that HPV-associated OPSCC was more likely to occur in nonsmokers (39.5% vs. 15.1%, OR: 2.89, P = 0.05), nondrinkers (52.5% vs. 25.6%, OR: 2.72, P = 0.04), originate from the palatine tonsils (83.7% vs. 53.7%, OR: 3.88, P = 0.01), present with an early primary tumor (T1/2; 79.1% vs. 47.6%, OR: 3.81, P = 0.004), and exhibit basaloid differentiation (33.3% vs. 7.3%, OR: 19.74, P = 0.006). HPV positivity was an independent predictor for better prognosis for both 5-year overall and 5-year disease-specific survivals (DSS; 63.0% vs. 29.7%, HR: 0.33, P < 0.001, and 87.8% vs. 42.6%, HR: 0.16, P < 0.001, respectively). CONCLUSION The estimated age-standardized incidence of OPSCC in Hong Kong during the period 2005-2009 was 0.12/100,000/year. IMPACT This study has provided the most comprehensive clinical and pathologic information to date about this newly recognized disease in southern Chinese. In view of the global trend, we should anticipate and prepare for an increase in HPV-related OPSCC in southern China.
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Affiliation(s)
- Eddy W H Lam
- Department of Otorhinolaryngology, Head and Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Jimmy Y W Chan
- Department of Surgery, Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Amy B W Chan
- Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Chi Sing Ng
- Department of Pathology, Caritas Medical Center, Hong Kong Special Administrative Region, People's Republic of China
| | - Stephen T H Lo
- Department of Pathology, Caritas Medical Center, Hong Kong Special Administrative Region, People's Republic of China
| | - Vincent S C Lam
- Department of Radiology, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Michael M H Chan
- Department of Otorhinolaryngology, Head and Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Chi Man Ngai
- Department of Otorhinolaryngology, Head and Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Alexander C Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Raymond K H Ma
- Department of Otorhinolaryngology, Head and Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, People's Republic of China.
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Liu X, Ma X, Lei Z, Feng H, Wang S, Cen X, Gao S, Jiang Y, Jiang J, Chen Q, Tang Y, Tang Y, Liang X. Chronic Inflammation-Related HPV: A Driving Force Speeds Oropharyngeal Carcinogenesis. PLoS One 2015; 10:e0133681. [PMID: 26193368 PMCID: PMC4507986 DOI: 10.1371/journal.pone.0133681] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/29/2015] [Indexed: 02/05/2023] Open
Abstract
Oropharyngeal squamous cell carcinoma (OPSCC) has been known to be a highly aggressive disease associated with human papilloma virus (HPV) infection. To investigate the relationship between HPV and chronic inflammation in oropharyngeal carcinogenesis, we collected 140 oral mucous fresh specimens including 50 OPSCC patients, 50 cancer in situ, 30 precancerous lesions, and 10 normal oral mucous. Our data demonstrated that there was a significantly higher proportion of severe chronic inflammation in dysplastic epithelia in comparison with that in normal tissues (P<0.001). The positive rate of HPV 16 was parallel with the chronic inflammation degrees from mild to severe inflammation (P<0.05). The positive rate of HPV 16 was progressively improved with the malignant progression of oral mucous (P<0.05). In addition, CD11b+ LIN- HLA-DR-CD33+ MDSCs were a critical cell population that mediates inflammation response and immune suppression in HPV-positive OPSCC. These indicated that persistent chronic inflammation-related HPV infection might drive oropharyngeal carcinogenesis and MDSCs might pay an important role during this process. Thus, a combination of HPV infection and inflammation expression might become a helpful biomedical marker to predict oropharyngeal carcinogenesis.
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Affiliation(s)
- Xin Liu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Xiangrui Ma
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Zhengge Lei
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Hao Feng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Shasha Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Xiao Cen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Shiyu Gao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Yaping Jiang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Jian Jiang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
| | - Yajie Tang
- Key Laboratory of Fermentation Engineering (Ministry of Education), Hubei University of Technology, Wuhan, China
| | - Yaling Tang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology (Sichuan University), Chengdu, China
- * E-mail: (XL); (YT)
| | - Xinhua Liang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology (Sichuan University), Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology (Sichuan University), Chengdu, China
- * E-mail: (XL); (YT)
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Chibaudel B, Lacave R, Lefevre M, Soussan P, Antoine M, Périé S, Belloc JB, Banal A, Albert S, Chabolle F, Céruse P, Baril P, Gatineau M, Housset M, Moukoko R, Benetkiewicz M, de Gramont A, Bonnetain F, Lacau St Guily J. Induction therapy with cetuximab plus docetaxel, cisplatin, and 5-fluorouracil (ETPF) in patients with resectable nonmetastatic stage III or IV squamous cell carcinoma of the oropharynx. A GERCOR phase II ECHO-07 study. Cancer Med 2015; 4:721-31. [PMID: 25684313 PMCID: PMC4430265 DOI: 10.1002/cam4.408] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/19/2014] [Accepted: 12/10/2014] [Indexed: 01/22/2023] Open
Abstract
Induction TPF regimen is a standard treatment option for squamous cell carcinoma (SCC) of the oropharynx. The efficacy and safety of adding cetuximab to induction TPF (ETPF) therapy was evaluated. Patients with nonmetastatic resectable stage III/IV SCC of the oropharynx were treated with weekly cetuximab followed the same day by docetaxel and cisplatin and by a continuous infusion of 5-fluorouracil on days 1-5 (every 3 weeks, 3 cycles). The primary endpoint was clinical and radiological complete response (crCR) of primary tumor at 3 onths. Secondary endpoints were crCR rates, overall response, pathological CR, progression-free survival, overall survival, and safety. Forty-two patients were enrolled, and 41 received ETPF. The all nine planned cetuximab doses and the full three doses of planned chemotherapy were completed in 31 (76%) and 36 (88%) patients, respectively. Twelve (29%) patients required dose reduction. The crCR of primary tumor at the completion of therapy was observed in nine (22%) patients. ETPF was associated with a tumor objective response rate (ORR) of 58%. The most frequent grade 3-4 toxicities were as follows: nonfebrile neutropenia (39%), febrile neutropenia (19%), diarrhea (10%), and stomatitis (12%). Eighteen (44%) patients experienced acne-like skin reactions of any grade. One toxic death occurred secondary to chemotherapy-induced colitis with colonic perforation. This phase II study reports an interesting response rate for ETPF in patients with moderately advanced SCC of the oropharynx. The schedule of ETPF evaluated in this study cannot be recommended at this dosage.
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Affiliation(s)
- Benoist Chibaudel
- Division of Medical Oncology, Franco-British Hospital InstituteLevallois-Perret, France
- GERCOR (Cooperator Multidisciplinary Oncology Group)Paris, France
- GERCOR-IRC (GERCOR-Innovative Research Consortium)Paris, France
| | - Roger Lacave
- Department of Histology and Tumor Biology, Hospital TenonParis, France
- ER2 Division, University Pierre et Marie CurieParis, France
- Clinical Research Group (GRC), Hospital TenonParis, France
| | - Marine Lefevre
- Division of Anatomic Pathology, Hospital TenonParis, France
| | | | | | - Sophie Périé
- Department of Otorhinolaryngology-Cervicofacial Surgery, Hospital TenonParis, France
| | - Jean-Baptiste Belloc
- Department of Otorhinolaryngology-Maxillofacial Surgery, Hospital Simone VeilMontmorency, France
| | - Alain Banal
- Department of Otorhinolaryngology-Head and Neck Surgery, Centre René HugueninSaint-Cloud, France
| | - Sébastien Albert
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Bichat-Claude BernardParis, France
| | - Frédéric Chabolle
- Department of Otolaryngology and Cervicofacial Surgery, Hospital FochSuresnes, France
| | - Philippe Céruse
- Department of Otorhinolaryngology-Cervicofacial Surgery, Hospital center Lyon-SudLyon, France
| | - Philippe Baril
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital DelafontaineSaint-Denis, France
| | - Michel Gatineau
- Medical Oncology Service, Groupe Hospitalier Saint JosephParis, France
| | - Martin Housset
- Department of Radiation Oncology, Georges Pompidou European HospitalParis, France
| | - Rachel Moukoko
- GERCOR (Cooperator Multidisciplinary Oncology Group)Paris, France
| | | | - Aimery de Gramont
- Division of Medical Oncology, Franco-British Hospital InstituteLevallois-Perret, France
- GERCOR (Cooperator Multidisciplinary Oncology Group)Paris, France
- GERCOR-IRC (GERCOR-Innovative Research Consortium)Paris, France
| | - Franck Bonnetain
- Methodological and Quality of Life in Oncology Unit (EA3181) & Quality of Life and Cancer Clinical Research Platform, Besançon University HospitalBesançon, France
| | - Jean Lacau St Guily
- ER2 Division, University Pierre et Marie CurieParis, France
- Clinical Research Group (GRC), Hospital TenonParis, France
- Department of Otorhinolaryngology-Cervicofacial Surgery, Hospital TenonParis, France
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Prevalence of HPV infection in head and neck carcinomas shows geographical variability: a comparative study from Brazil and Germany. Virchows Arch 2015; 466:685-93. [PMID: 25820374 DOI: 10.1007/s00428-015-1761-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 02/16/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
Rising prevalence rates of high-risk human papillomaviruses (hrHPV) infection in oropharyngeal carcinoma (up to 80 %) have been reported in North America and Scandinavia. We have analysed 424 German and 163 Brazilian head and neck squamous cell carcinomas (HNSCC) from the oral cavity (OSCC), oropharynx (OPSCC) and hypopharynx (HPSCC) using p16 immunohistochemistry, HPV DNA PCR and sequencing, hrHPV DNA in situ hybridisation (ISH) and hrHPV E6/E7 RNA ISH. In the German series, 52/424 cases (12.3 %) were p16-positive/hrHPV-positive (OSCC 3.8 % [10/265], OPSCC 34.4 % [42/122], HPSCC 0 % [0/37]). In addition, there were 9 cases that were p16-positive/hrHPV-negative (5 OPSCC and 4 OSCC). In the Brazilian series, the overall hrHPV DNA prevalence by PCR was 11.0 % ([18/163]; OSCC 6 % [5/83], OPSCC 15.5 % [11/71], HPSCC 22.2 % [2/9]). Ten of these cases were hrHPV-positive/p16-positive. The remaining 8 hrHPV-positive/p16-negative cases were also negative in both ISH assays. Furthermore, 5 p16-positive/hrHPV-negative cases (2 OPSCC and 3 OSCC) were identified. In both series, HPV16 was by far the most common HPV type detected. We confirm that regardless of geographical origin, the highest hrHPV prevalence in HNSCC is observed in oropharyngeal carcinomas. The proportion of HPV-associated OPSCC was substantially higher in the German cohort than in the Brazilian series (34.4 vs. 15.5 %), and in both groups, the prevalence of hrHPV in OPSCC was much lower than in recent reports from North America and Scandinavia. We suggest, therefore, that it may be possible to define areas with high (e.g. USA, Canada, Scandinavia), intermediate (e.g. Germany) and low (e.g. Brazil) prevalences of HPV infection in OPSCC.
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Hernandez BY, Goodman MT, Lynch CF, Cozen W, Unger ER, Steinau M, Thompson T, Saber MS, Altekruse SF, Lyu C, Saraiya M. Human papillomavirus prevalence in invasive laryngeal cancer in the United States. PLoS One 2014; 9:e115931. [PMID: 25546150 PMCID: PMC4278830 DOI: 10.1371/journal.pone.0115931] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/27/2014] [Indexed: 12/21/2022] Open
Abstract
Purpose Human papillomavirus (HPV) is a major risk factor for specific cancers of the head and neck, particularly malignancies of the tonsil and base of the tongue. However, the role of HPV in the development of laryngeal cancer has not been definitively established. We conducted a population-based, cancer registry study to evaluate and characterize the genotype-specific prevalence of HPV in invasive laryngeal cancer cases diagnosed in the U.S. Methods The presence of genotype-specific HPV DNA was evaluated using the Linear Array HPV Genotyping Test and the INNO-LiPA HPV Genotyping Assay in formalin-fixed paraffin embedded tissue from 148 invasive laryngeal cancer cases diagnosed in 1993–2004 within the catchment area of three U.S. SEER cancer registries. Results HPV DNA was detected in 31 of 148 (21%) invasive laryngeal cancers. Thirteen different genotypes were detected. Overall, HPV 16 and HPV 33 were the most commonly detected types. HPV was detected in 33% (9/27) of women compared with 18% (22/121) of men (p = 0.08). After adjustment for age and year of diagnosis, female patients were more likely to have HPV-positive laryngeal tumors compared to males (adjusted OR 2.84, 95% CI 1.07–7.51). Viral genotype differences were also observed between the sexes. While HPV 16 and 18 constituted half of HPV-positive cases occurring in men, among women, only 1 was HPV 16 positive and none were positive for HPV 18. Overall 5-year survival did not vary by HPV status. Conclusions HPV may be involved in the development of a subset of laryngeal cancers and its role may be more predominant in women compared to men.
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Affiliation(s)
- Brenda Y. Hernandez
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, United States of America
- * E-mail:
| | - Marc T. Goodman
- Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Charles F. Lynch
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, United States of America
| | - Wendy Cozen
- Norris Comprehensive Cancer Center and Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Martin Steinau
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Trevor Thompson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Maria Sibug Saber
- Norris Comprehensive Cancer Center and Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Sean F. Altekruse
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
| | - Christopher Lyu
- Battelle Memorial Institute, Durham, North Carolina, United States of America
| | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Vietía D, Liuzzi J, Avila M, De Guglielmo Z, Prado Y, Correnti M. Human papillomavirus detection in head and neck squamous cell carcinoma. Ecancermedicalscience 2014; 8:475. [PMID: 25374623 PMCID: PMC4208923 DOI: 10.3332/ecancer.2014.475] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Indexed: 01/29/2023] Open
Abstract
Introduction Human Papillomavirus (HPV) has been associated with benign and malignant lesions in different epitheliums. The relationship between specific genotypes of high-risk HPV and some human cancers is well established. The aim of this work was to detect the HPV genotypes present in head and neck squamous cell carcinoma (HNSCC). Methods We evaluated 71 samples of patients with histopathological diagnosis of HNSCC. The DNA extraction was conducted with the QIAGEN commercial kit. HPV detection and genotyping were performed by reverse hybridisation (INNO-LiPA) following the commercial specifications. Results The mean age of the patients evaluated was 60.7 ± 13.11 years. The distribution of the lesions included 25 (35.20%) cases of squamous cell carcinoma (SCC) of the oral cavity, 23 (32.39%) of larynx, 16 (22.50%) of the oropharynx, 4 (5.63%) of paranasal sinus, and 2 (2. 80%) cases of SCC of the nostril. Of the patients, 78.9% were males, and of these 76% were tobacco users and 67.6% were alcohol consumers. The viral DNA was detected in 67.6% of the samples. The oral cavity and the larynx were the highest HPV-positivity sites with 35.40% and 29.10% respectively. The most frequent genotype was 16 as single infection (18.70%), or in combination with another HPV types. In the oral cavity and larynx the genotypes 16 or the combination 6 and 51 were present in 11.76% and 14.28%, respectively; and in the oropharynx the most frequent genotype was 16 in 22.50% of the cases, and in the paranasal sinus 50% presented infection with HPV-6. We observed that tumours with most advanced size and stage presented greater HPV positivity. Conclusions This study shows a high percentage of HPV positivity in SCC is mainly associated with high-risk HPV. It is important to highlight that viral infection, especially HPV-16, could be a risk factor in HNSCC progression.
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Affiliation(s)
- Dayahindara Vietía
- Laboratorio de Genética Molecular, Instituto de Oncología y Hematología-MPPS, Caracas 1050, Venezuela
| | - Juan Liuzzi
- Servicio de cabeza y cuello del Hospital Oncológico 'Padre Machado'-IVSS, Caracas 1050, Venezuela
| | - Maira Avila
- Laboratorio de Genética Molecular, Instituto de Oncología y Hematología-MPPS, Caracas 1050, Venezuela
| | - Zoraya De Guglielmo
- Laboratorio de Genética Molecular, Instituto de Oncología y Hematología-MPPS, Caracas 1050, Venezuela
| | - Yrneh Prado
- Laboratorio de Genética Molecular, Instituto de Oncología y Hematología-MPPS, Caracas 1050, Venezuela
| | - María Correnti
- Laboratorio de Genética Molecular, Instituto de Oncología y Hematología-MPPS, Caracas 1050, Venezuela
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Theurer JA, Yoo J, Nichols AC. Human papillomavirus-related oropharyngeal squamous cell carcinoma: a new context for dysphagia rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2014. [DOI: 10.1007/s40141-014-0058-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hama T, Tokumaru Y, Fujii M, Yane K, Okami K, Kato K, Masuda M, Mineta H, Nakashima T, Sugasawa M, Sakihama N, Yoshizaki T, Hanazawa T, Kato H, Hirano S, Imanishi Y, Kuratomi Y, Otsuki N, Ota I, Sugimoto T, Suzuki S. Prevalence of human papillomavirus in oropharyngeal cancer: a multicenter study in Japan. Oncology 2014; 87:173-82. [PMID: 25033838 DOI: 10.1159/000360991] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 02/27/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The incidence rates of oropharyngeal squamous cell carcinoma (OPSCC) have risen steadily in the USA and in northern Europe. These increases are thought to be a consequence of persistent infection with high-risk human papillomavirus (HPV) in OPSCC patients. HPV is an emerging etiologic factor in OPSCC. In Japan, the incidence of OPSCC has significantly increased over the last three decades. However, the population of HPV-positive OPSCC patients is currently unknown. We examined the nationwide trends with regard to HPV incidence in OPSCC patients at 21 specific sites, and examined the relationship between the presence of HPV and survival in OPSCC patients in Japan. METHODS Tumor samples were obtained from patients with OPSCC prior to treatment, and HPV infection was investigated by polymerase chain reaction (PCR). Hybrid Capture 2 (HC2) was also adopted for swab examination on the surface of fresh tumors. RESULTS HPV was detected by PCR in 79 (50.3%) out of 157 OPSCC patients. The clinical features of HPV-positive OPSCC were low differentiation, a tendency to involve the lateral wall, and high nodal staging. The sensitivity and specificity of HC2 were 93.7 and 96.2%, respectively, indicating its utility as a screening test. HPV-positive patients had significantly better overall survival and disease-free survival than HPV-negative patients.
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Affiliation(s)
- Takanori Hama
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
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Kwon MJ, Kim DH, Park HR, Shin HS, Kwon JH, Lee DJ, Kim JH, Cho SJ, Nam ES. Frequent hepatocyte growth factor overexpression and low frequency of c-Met gene amplification in human papillomavirus–negative tonsillar squamous cell carcinoma and their prognostic significances. Hum Pathol 2014; 45:1327-38. [DOI: 10.1016/j.humpath.2014.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/07/2014] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
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Pytynia KB, Dahlstrom KR, Sturgis EM. Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol 2014; 50:380-6. [PMID: 24461628 PMCID: PMC4444216 DOI: 10.1016/j.oraloncology.2013.12.019] [Citation(s) in RCA: 338] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 11/12/2013] [Accepted: 12/17/2013] [Indexed: 02/06/2023]
Abstract
Squamous cell carcinoma of the oropharynx is increasing in incidence in epidemic proportion. This site specific increase in incidence is due to an increase in human papillomavirus (HPV)-related squamous cell carcinoma, while the incidence of tobacco related squamous cell carcinoma is decreasing. In particular, the incidence of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) is increased among middle aged white men, and sexual behavior is a risk factor. HPV-related oropharyngeal squamous cell carcinoma represents a growing etiologically distinct subset of head and neck cancers with unique epidemiological, clinical, and molecular characteristics that differ from those of HPV-unassociated cancers. In this review, we discuss the epidemiology of HPV-related OPSCC, the prevalence of oral/oropharyngeal HPV infection, and efforts aimed at reducing the incidence of HPV-related OPSCC.
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Affiliation(s)
- Kristen B Pytynia
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Kristina R Dahlstrom
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Erich M Sturgis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Hernandez BY, Goodman MT, Unger ER, Steinau M, Powers A, Lynch CF, Cozen W, Saber MS, Peters ES, Wilkinson EJ, Copeland G, Hopenhayn C, Huang Y, Watson M, Altekruse SF, Lyu C, Saraiya M. Human papillomavirus genotype prevalence in invasive penile cancers from a registry-based United States population. Front Oncol 2014; 4:9. [PMID: 24551592 PMCID: PMC3914298 DOI: 10.3389/fonc.2014.00009] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 01/17/2014] [Indexed: 01/05/2023] Open
Abstract
Background: Human papillomavirus (HPV) is estimated to play an etiologic role in 40–50% of penile cancers worldwide. Estimates of HPV prevalence in U.S. penile cancer cases are limited. Methods: HPV DNA was evaluated in tumor tissue from 79 invasive penile cancer patients diagnosed in 1998–2005 within the catchment areas of seven U.S. cancer registries. HPV was genotyped using PCR-based Linear Array and INNO-LiPA assays and compared by demographic, clinical, and pathologic characteristics and survival. Histological classification was also obtained by independent pathology review. Results: HPV DNA was present in 50 of 79 (63%) of invasive penile cancer cases. Sixteen viral genotypes were detected. HPV 16, found in 46% (36/79) of all cases (72% of HPV-positive cases) was the most prevalent genotype followed equally by HPV 18, 33, and 45, each of which comprised 5% of all cases. Multiple genotypes were detected in 18% of viral positive cases. HPV prevalence did not significantly vary by age, race/ethnicity, population size of geographic region, cancer stage, histology, grade, penile subsite, or prior cancer history. Penile cases diagnosed in more recent years were more likely to be HPV-positive. Overall survival did not significantly vary by HPV status. Conclusion: The relatively high prevalence of HPV in our study population provides limited evidence of a more prominent and, possibly, increasing role of infection in penile carcinogenesis in the U.S. compared to other parts of the world.
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Affiliation(s)
- Brenda Y Hernandez
- University of Hawaii Cancer Center, University of Hawaii , Honolulu, HI , USA
| | - Marc T Goodman
- University of Hawaii Cancer Center, University of Hawaii , Honolulu, HI , USA
| | - Elizabeth R Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, GA , USA
| | - Martin Steinau
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, GA , USA
| | - Amy Powers
- University of Hawaii Cancer Center, University of Hawaii , Honolulu, HI , USA
| | - Charles F Lynch
- Department of Epidemiology, College of Public Health, The University of Iowa , Iowa City, IA , USA
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California , Los Angeles, CA , USA
| | - Maria Sibug Saber
- Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California , Los Angeles, CA , USA
| | - Edward S Peters
- Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center , New Orleans, LA , USA
| | - Edward J Wilkinson
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida , Gainesville, FL , USA
| | - Glenn Copeland
- Michigan Department of Community Health , Lansing, MI , USA
| | - Claudia Hopenhayn
- Department of Epidemiology, College of Public Health, University of Kentucky , Lexington, KY , USA
| | - Youjie Huang
- Florida Department of Health , Tallahassee, FL , USA
| | - Meg Watson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention, and Health Promotion, Centers for Disease Control and Prevention , Atlanta, GA , USA
| | - Sean F Altekruse
- Division of Cancer Control and Population Sciences, National Cancer Institute , Rockville, MD , USA
| | | | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention, and Health Promotion, Centers for Disease Control and Prevention , Atlanta, GA , USA
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Psyrri A, Burtness B. Viruses in head and neck cancers: prevention and therapy. Expert Rev Anticancer Ther 2014; 8:1365-71. [DOI: 10.1586/14737140.8.9.1365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Benson E, Li R, Eisele D, Fakhry C. The clinical impact of HPV tumor status upon head and neck squamous cell carcinomas. Oral Oncol 2013; 50:565-74. [PMID: 24134947 DOI: 10.1016/j.oraloncology.2013.09.008] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/30/2013] [Accepted: 09/13/2013] [Indexed: 02/02/2023]
Abstract
Human papillomavirus (HPV) is etiologically responsible for a distinct subset of head and neck squamous cell cancers (HNSCCs). HPV-positive HNSCCs (HPV-HNSCCs) most commonly arise from the oropharynx and are responsible for the increasing incidence of oropharyngeal SCC (OSCC) in the United States (US) and abroad. HPV-positive OSCC (HPV-OSCC) has a unique demographic and risk factor profile and tumor biology. HPV-OSCC patients tend to be white, younger, and have a higher cumulative exposure to sexual behaviors as compared with HPV-negative OSCC patients. HPV-positive tumor status also significantly improves survival, and is indeed the single strongest prognostic factor for OSCC. The mechanisms that underlie the improved prognosis conferred by HPV-positive disease are unknown. The purpose of this review is to describe the clinical impact of HPV status in HNSCC, particularly in OSCC, both in terms of the unique clinic-demographic profile and prognostic implications.
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Affiliation(s)
- Eleni Benson
- Johns Hopkins Medical Institutions, Department of Otolaryngology-Head and Neck Surgery., 601 N. Caroline Street, 6th Floor, Baltimore, MD 21287, United States.
| | - Ryan Li
- Johns Hopkins Medical Institutions, Department of Otolaryngology-Head and Neck Surgery., 601 N. Caroline Street, 6th Floor, Baltimore, MD 21287, United States.
| | - David Eisele
- Johns Hopkins Medical Institutions, Department of Otolaryngology-Head and Neck Surgery., 601 N. Caroline Street, 6th Floor, Baltimore, MD 21287, United States.
| | - Carole Fakhry
- Johns Hopkins Medical Institutions, Department of Otolaryngology-Head and Neck Surgery., 601 N. Caroline Street, 6th Floor, Baltimore, MD 21287, United States; Milton J. Dance Jr. Head and Neck Cancer Center, Baltimore, MD 21204, United States; Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615 N Wolfe St., Baltimore, MD 21205, United States.
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Petrelli F, Sarti E, Barni S. Predictive value of human papillomavirus in oropharyngeal carcinoma treated with radiotherapy: An updated systematic review and meta-analysis of 30 trials. Head Neck 2013; 36:750-9. [DOI: 10.1002/hed.23351] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/27/2013] [Accepted: 04/09/2013] [Indexed: 11/06/2022] Open
Affiliation(s)
- Fausto Petrelli
- Medical Oncology Unit; Oncology Department; Azienda Ospedaliera Treviglio, Piazzale Ospedale 1 24047 Treviglio (BG) Italy
| | - Enrico Sarti
- Radiotherapy Unit; Oncology Department; Azienda Ospedaliera Treviglio, Piazzale Ospedale 1 24047 Treviglio (BG) Italy
| | - Sandro Barni
- Medical Oncology Unit; Oncology Department; Azienda Ospedaliera Treviglio, Piazzale Ospedale 1 24047 Treviglio (BG) Italy
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