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Nibu K, Oridate N, Saito Y, Roset M, Forés Maresma M, Cuadras D, Morais E, Roberts C, Chen Y, Spitzer J, Sato K, Saito I, Tazaki I, Clavero O, Schroeder L, Alemany L, Mehanna H, Mirghani H, Giuliano AR, Pavón MA, Waterboer T. Human papillomavirus-driven head and neck cancers in Japan during 2008-2009 and 2018-2019: The BROADEN study. Cancer Sci 2024; 115:2808-2818. [PMID: 38847353 PMCID: PMC11309946 DOI: 10.1111/cas.16230] [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: 11/07/2023] [Revised: 04/18/2024] [Accepted: 05/11/2024] [Indexed: 08/10/2024] Open
Abstract
There is limited understanding of epidemiology and time trends of human papilloma virus (HPV)-driven head and neck cancers (HNC) in Japan, especially outside of the oropharynx. To assess HPV-driven HNC, a non-interventional study (BROADEN) of HNC patients diagnosed in 2008-2009 and 2018-2019 was conducted in Japan. Adult patients with oropharyngeal, nasopharyngeal, laryngeal, hypopharyngeal or oral cavity cancers were included in this study. HPV was centrally tested using p16INK4a immunohistochemistry, HPV-DNA PCR and HPV E6*I mRNA. HPV attributability required positivity in at least two tests (p16INK4a immunohistochemistry, HPV-DNA PCR, HPV E6*I mRNA) in the oropharynx, and HPV-DNA and HPV E6*I mRNA positivity for non-oropharynx sites. Nineteen hospitals included a total of 1108 patients, of whom 981 had valid samples. Men accounted for 82% of HNC diagnoses. Patients in the earlier cohort were younger and included a higher percentage of smokers. There was an increasing trend of HPV-driven oropharyngeal cancer over the last decade, from 44.2% to 51.7%. HPV attribution in nasopharyngeal cancers was 3.2% in 2008-2009 and 7.5% in 2018-2019; and 4.4% and 0% for larynx respectively. In total, 95.2% of HPV-driven HNC were attributed to HPV genotypes included in the 9-valent HPV vaccine being HPV16 the most prominent genotype. These results suggest that an epidemiologic shift is happening in Japan, with a decrease in smoking and alcohol use and an increase in HPV-driven HNC. The increasing trend of HPV-driven HNC in Japan highlights the need for preventive strategies to mitigate the rise of HPV-driven HNC.
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Affiliation(s)
- Ken‐ichi Nibu
- Department of Otolaryngology‐Head and Neck SurgeryKobe University, Graduate School of MedicineKobeHyogoJapan
| | - Nobuhiko Oridate
- Department of Otolaryngology, Head and Neck Surgery, School of MedicineYokohama City UniversityYokohamaKanagawaJapan
| | - Yuki Saito
- Department of Otolaryngology, Head and Neck SurgeryUniversity of TokyoTokyoJapan
| | | | | | | | | | | | | | | | | | | | | | - Omar Clavero
- Cancer Epidemiology Research Program, Catalan Institute of OncologyIDIBELL, EPIBELLBarcelonaSpain
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP)Instituto de Salud Carlos IIIMadridSpain
| | - Lea Schroeder
- German Cancer Research Center (DKFZ)HeidelbergGermany
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of OncologyIDIBELL, EPIBELLBarcelonaSpain
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP)Instituto de Salud Carlos IIIMadridSpain
| | - Hisham Mehanna
- Institute of Head & Neck Studies and Education (InHANSE)University of BirminghamBirminghamUK
| | - Haitham Mirghani
- Department of Oto‐Rhino‐Laryngology and Head and Neck Surgery, Hôpital Européen Georges PompidouAPHP, Université Paris‐CitéParisFrance
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in CancerMoffitt Cancer Center and Research InstituteTampaFloridaUSA
| | - Miquel Angel Pavón
- Cancer Epidemiology Research Program, Catalan Institute of OncologyIDIBELL, EPIBELLBarcelonaSpain
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP)Instituto de Salud Carlos IIIMadridSpain
| | - Tim Waterboer
- German Cancer Research Center (DKFZ)HeidelbergGermany
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Kikuchi Y, Shimada H, Yamasaki F, Yamashita T, Araki K, Horimoto K, Yajima S, Yashiro M, Yokoi K, Cho H, Ehira T, Nakahara K, Yasuda H, Isobe K, Hayashida T, Hatakeyama S, Akakura K, Aoki D, Nomura H, Tada Y, Yoshimatsu Y, Miyachi H, Takebayashi C, Hanamura I, Takahashi H. Clinical practice guidelines for molecular tumor marker, 2nd edition review part 2. Int J Clin Oncol 2024; 29:512-534. [PMID: 38493447 DOI: 10.1007/s10147-024-02497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
In recent years, rapid advancement in gene/protein analysis technology has resulted in target molecule identification that may be useful in cancer treatment. Therefore, "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" was published in Japan in September 2021. These guidelines were established to align the clinical usefulness of external diagnostic products with the evaluation criteria of the Pharmaceuticals and Medical Devices Agency. The guidelines were scoped for each tumor, and a clinical questionnaire was developed based on a serious clinical problem. This guideline was based on a careful review of the evidence obtained through a literature search, and recommendations were identified following the recommended grades of the Medical Information Network Distribution Services (Minds). Therefore, this guideline can be a tool for cancer treatment in clinical practice. We have already reported the review portion of "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" as Part 1. Here, we present the English version of each part of the Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition.
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Affiliation(s)
| | - Hideaki Shimada
- Department of Clinical Oncology, Toho University, Tokyo, Japan.
- Department of Surgery, Toho University, Tokyo, Japan.
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Koji Araki
- Department of Otorhinolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | - Masakazu Yashiro
- Department of Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Keigo Yokoi
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Haruhiko Cho
- Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Takuya Ehira
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazunari Nakahara
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroshi Yasuda
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazutoshi Isobe
- Division of Respiratory Medicine, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | - Daisuke Aoki
- International University of Health and Welfare Graduate School, Tokyo, Japan
| | - Hiroyuki Nomura
- Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yuji Tada
- Department of Pulmonology, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Yuki Yoshimatsu
- Department of Patient-Derived Cancer Model, Tochigi Cancer Center Research Institute, Tochigi, Japan
| | - Hayato Miyachi
- Faculty of Clinical Laboratory Sciences, Nitobe Bunka College, Tokyo, Japan
| | - Chiaki Takebayashi
- Division of Hematology and Oncology, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
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Fonsêca TC, Jural LA, Marañón-Vásquez GA, Magno MB, Roza ALOC, Ferreira DMTP, Maia LC, Romañach MJ, Agostini M, Abrahão AC. Global prevalence of human papillomavirus-related oral and oropharyngeal squamous cell carcinomas: a systematic review and meta-analysis. Clin Oral Investig 2023; 28:62. [PMID: 38158517 DOI: 10.1007/s00784-023-05425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To conduct a systematic review to determine the global prevalence of HPV in oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS Literature was searched through October 2022 in main databases to address the question "What is the global prevalence of Human Papillomavirus in oral and oropharyngeal cancer?" Studies had to identify HPV by PCR, ISH, or p16 immunohistochemistry to be eligible. Quality was assessed using the JBI checklist for prevalence studies. Meta-analyses were performed, and reporting followed PRISMA guidelines. RESULTS Sixty-five studies were included, and most of them had methodological limitations related to sampling and the HPV detection tool. The pooled prevalence of HPV-positivity was 10% (event rate = 0.1; 95% CI: 0.07, 0.13; P < 0.01; I2 = 88%) in the oral cavity and 42% (event rate = 0.42; 95% CI: 0.36, 0.49; P = 0.02; I2 = 97%) in oropharynx. The highest HPV prevalence in OSCC was reached by Japan, meanwhile, in OPSCC, Finland and Sweden were the most prevalent. HPV16 is the genotype most frequent with 69% in OSCC and 89% in OPSCC, being the tonsils the intraoral location more affected by HPV (63%, p < 0.01, I2 76%). CONCLUSION The evidence points to an apparent burden in HPV-related OPSCC, mostly in North America, Northern Europe, and Oceania, especially due to the HPV16 infection suggesting different trends across continents. CLINICAL RELEVANCE This updated systematic review and meta-analysis provide sufficient evidence about the global HPV prevalence in OSCC and OPSCC and the most frequent HPV subtype worldwide.
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Affiliation(s)
- Thamyres Campos Fonsêca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Guido Artemio Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Aline Correa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil.
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Horakova Z, Starek I, Salzman R. Current status and future perspectives of oral HPV testing in the diagnosis and monitoring of oropharyngeal cancer. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:319-327. [PMID: 37901925 DOI: 10.5507/bp.2023.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/02/2023] [Indexed: 10/31/2023] Open
Abstract
HPV16 status in oropharyngeal cancer (OPC) is an important prognostic factor. Its determination, based on immunistochemical analysis of p16 oncoprotein requires an invasive biopsy. Thus, alternative methods are being sought. Determining oral HPV16 status appears to be a promising alternative. However, it is not used routinely. This prompted us to perform a systematic literature review enabling us to evaluate the diagnostic and predictive ability of this approach. Thirty-four relevant studies were finally selected. For determination of HPV status in OPC, the calculated average sensitivity and specificity for oral sampling was 74% and 91%, respectively, with p16 tumour tissue marker being the gold standard. The method appears to be valuable in monitoring treatment response as well as the biological activity of the tumour, enabling early detection of persistent or relapsing carcinoma sufficiently long before its clinical and/or radiological manifestation. It can also contribute to identification of the primary tumour in cases of metastases of unknown origin. Last but not least, the screening HPV oral testing would help to identify individuals with persistent HPV oral infection who are at increased risk of development of OPC.
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Affiliation(s)
- Zuzana Horakova
- Clinic of ENT and Head and Neck Surgery, University Hospital Olomouc, Palacky University Olomouc, Zdravotniku 248/7, 779 00, Olomouc, Czech Republic
| | - Ivo Starek
- Clinic of ENT and Head and Neck Surgery, University Hospital Olomouc, Palacky University Olomouc, Zdravotniku 248/7, 779 00, Olomouc, Czech Republic
| | - Richard Salzman
- Clinic of ENT and Head and Neck Surgery, University Hospital Olomouc, Palacky University Olomouc, Zdravotniku 248/7, 779 00, Olomouc, Czech Republic
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Sathasivam HP, Davan SP, Chua SM, Rohaizat RF, Japar R, Zakaria Z, Ahmad AR, Hashim H, Marimuthu SG, Liew YT, Yong DJ, Vairavan P, Mohan Singh AS, Goh BHB, Yusof Z, Abu Dahari KAS, Haron A, Mansor M, Ibrahim MZ, Muhammad Abdul Kadar SQ, Hamal MH, Wan Mohamad WE. Findings from a Malaysian multicentre study on oropharyngeal squamous cell carcinoma. Infect Agent Cancer 2023; 18:74. [PMID: 38017493 PMCID: PMC10683110 DOI: 10.1186/s13027-023-00557-0] [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: 09/12/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND In addition to the conventional aetiologic agents of oropharyngeal squamous cell carcinoma (OPSCC) such as tobacco usage, alcohol consumption and betel quid usage, it has been established that a proportion of OPSCC are driven by persistent oncogenic human papillomavirus (HPV) infections. Currently, there is a lack of data on the burden of HPV- associated OPSCC in Asian countries including Malaysia. METHODS A cross-sectional multicentre study with tissue analysis of Malaysian patients diagnosed with primary OPSCC within a five-year period, from 2015 to 2019 between 01/01/2015 to 31/12/2019 was undertaken. Determination of HPV status was carried out using p16INK4a immunohistochemistry on tissue microarrays constructed from archived formalin-fixed paraffin-embedded tissue. RESULTS From the cases identified, 184 cases had sufficient tissue material for analysis. Overall, median age at diagnosis was 63.0 years (IQR = 15) and 76.1% of patients were males. In our cohort, 35.3% of patients were Indian, 34.2% were Chinese, 21.2% were Malay and 9.2% were from other ethnicities. The estimated prevalence of HPV-associated OPSCC in our cohort was 31.0% (CI 24.4-38.2%). The median age for the HPV-associated OPSCC sub-group of patients was not significantly lower than the median age of patients with HPV-independent OPSCC. More than half of HPV-associated OPSCC was seen in patients of Chinese ethnicity (54.4%). Patients with HPV-associated OPSCC had a much better overall survival than patients with HPV-independent OPSCC (Log rank test; p < 0.001). Patients with HPV-associated OPSCC with no habit-related risk factors such as smoking, were found to have much better overall survival when compared to all other sub-groups. CONCLUSIONS The findings from our study suggests that prevalence of HPV-associated OPSCC in Malaysia, though not as high as some developed countries, is however on an upward trend. HPV-associated OPSCC appears to be more frequently encountered in patients of Chinese ethnicity. Conventional risk-factors associated with OPSCC such as smoking, alcohol consumption and betel quid chewing should still be considered when estimating prognosis of patients with HPV-associated OPSCC.
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Affiliation(s)
- Hans Prakash Sathasivam
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Malaysia.
| | - Sangeetha Passu Davan
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Szu May Chua
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Rahmuna Fazlina Rohaizat
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Rohaizam Japar
- Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Zahirrudin Zakaria
- Hospital Pulau Pinang, Ministry of Health Malaysia, Pulau Pinang, Malaysia
| | - Abd Razak Ahmad
- Hospital Melaka, Ministry of Health Malaysia, Melaka, Malaysia
| | - Hasmah Hashim
- Hospital Melaka, Ministry of Health Malaysia, Melaka, Malaysia
| | | | | | - Doh Jeing Yong
- Hospital Queen Elizabeth, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Pappathy Vairavan
- Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | | | | | - Zulkifli Yusof
- Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia
| | | | - Ali Haron
- Hospital Raja Perempuan Zainab II, Ministry of Health Malaysia, Kota Bharu, Malaysia
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Lau F, Lisatchok M, Tamanini JB, Gazmenga FP, Texeira DNA, Couto EV, Chone CT. Treatment outcome of oropharyngeal squamous cell carcinoma through propensity score analysis. Braz J Otorhinolaryngol 2023; 89:101335. [PMID: 37813007 PMCID: PMC10570559 DOI: 10.1016/j.bjorl.2023.101335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/20/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023] Open
Abstract
According to an extensive database, the Objective is to compare surgical versus non-surgical treatment through Propensity Score (PS) for patients with Oropharyngeal Squamous Cell Carcinoma (OPSCC). METHODS We retrospectively evaluated epidemiological data from 8075 patients with OPSCC diagnosed between 2004 and 2014 and used PS matching to analyze possible prognostic factors for its outcomes with regression analyses. RESULTS Cox multiple regression analysis to study survival after PS matching shows that type of treatment was associated with death with a hazard ratio of 1.753 (p<0.05) of non-surgical treatment. However, it was not associated with recurrence (p>0.05). In the surgical treatment group, overall survival was 79.9% at one year, 36.4% at five years, and 20.5% at ten years. Disease-free survival was 90.1%, 64.8%, and 56.0% at 1, 5, and 10-years, respectively. In the non-surgical treatment group, overall survival was 60.6% at one year, 21.8% at five years, and 12.7% at ten years. Disease-free survival was 90.8%, 67.2%, and 57.8% at 1, 5, and 10-years, respectively. CONCLUSION Patients in the surgical treatment group had better outcomes related to survival. Recurrence is associated with the survival of OPSCC cancer. Recurrence-free survival is similar to both treatments. LEVEL OF EVIDENCE 2C.
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Affiliation(s)
- Fabio Lau
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
| | - Matheus Lisatchok
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Jonas Belchior Tamanini
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Fabio Portela Gazmenga
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Daniel Naves Araújo Texeira
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Eduardo Vieira Couto
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
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Fujita Y, Fukuda Y, Sanuki F, Irei I, Monobe Y, Uno M, Akisada T, Shimoya K, Hara H, Moriya T. Protease-Activated Receptor 1 (PAR1) Expression Contributes to HPV-Associated Oropharyngeal Cancer Prognosis. Head Neck Pathol 2023; 17:658-672. [PMID: 37486532 PMCID: PMC10514014 DOI: 10.1007/s12105-023-01567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/17/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Human papillomavirus (HPV)-associated oropharyngeal cancer occasionally has a poor prognosis, making prognostic risk stratification crucial. Protease-activated receptor-1 (PAR1) is involved in carcinogenesis, and its expression is regulated by alpha-arrestin domain-containing protein 3 (ARRDC3). It is also involved in the tumor microenvironment. We sought to evaluate the predictive ability of PAR1, ARRDC3, and tumor-infiltrating lymphocyte (TIL) scores in patients with oropharyngeal, hypopharyngeal, and uterine cervical cancers, serving as comparators for HPV-associated oropharyngeal cancer. METHODS Immunohistochemical analysis of p16, ARRDC3, and PAR1 expression was performed on 79 oropharyngeal, 44 hypopharyngeal, and 42 uterine cervical cancer samples. The TIL scores were assessed and classified into the following groups based on invasion: low: 0-10%, medium: 20-40%, and high: > 50%. For prognostic analysis, the three groups were evaluated by dividing them into low, medium, and high categories, or alternatively into two groups using the median value as the cutoff. RESULTS p16 was expressed in 44 (56%) oropharyngeal, 8 (18%) hypopharyngeal, and all uterine cervical cancer samples. ARRDC3 was detected in 39 (49%) oropharyngeal, 25 (57%) hypopharyngeal, and 23 (55%) uterine cervical cancer samples. PAR1 was expressed in 45 (57%) oropharyngeal, 22 (50%) hypopharyngeal, and 22 (50%) uterine cervical cancer samples. Patients diagnosed with p16-positive oropharyngeal cancer had a substantially improved prognosis compared to those diagnosed with p16-negative cancer. The PAR1-negative cases had a considerably improved prognosis compared to the positive cases (disease-specific survival [DSS] and -negative cases (disease-free survival [DFS]). Multivariate analysis revealed that ARRDC3-positive cases had an appreciably better DSS prognosis than patients with p16-negative oropharyngeal cancers. PAR1-positive patients among patients with p16-positive oropharyngeal cancer had a poor prognosis. With respect to DFS, patients with PAR1-positive and p16-negative oropharyngeal cancer had a 35-fold higher recurrence rate than those with PAR1-negative and p16-negative oropharyngeal cancer. CONCLUSION Our results suggest that PAR1 expression affects the prognosis and recurrence rate of HPV-associated oropharyngeal cancer.
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Affiliation(s)
- Yoshinori Fujita
- Department of Pathology, Kawasaki Medical University, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
- Department of Otolaryngology, Head and Neck Surgery, Kawasaki Medical University, Kurashiki, Okayama, Japan
| | - Yujiro Fukuda
- Department of Otolaryngology, Head and Neck Surgery, Kawasaki Medical University, Kurashiki, Okayama, Japan
| | - Fumiaki Sanuki
- Department of Pathology, Kawasaki Medical University, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Isao Irei
- Department of Pathology, Kawasaki Medical University, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Yasumasa Monobe
- Department of Pathology, Kawasaki Medical University, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
| | - Masako Uno
- Department of Otolaryngology, Head and Neck Surgery, Kawasaki Medical University, Kurashiki, Okayama, Japan
| | - Takeshi Akisada
- Department of Otolaryngology, Head and Neck Surgery, Kawasaki Medical University, Kurashiki, Okayama, Japan
| | - Koichiro Shimoya
- Department of Obstetrics and Gynecology, Kawasaki Medical University, Kurashiki, Okayama, Japan
| | - Hirotaka Hara
- Department of Otolaryngology, Head and Neck Surgery, Kawasaki Medical University, Kurashiki, Okayama, Japan
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical University, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
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Shinomiya H, Nibu KI. Etiology, diagnosis, treatment, and prevention of human papilloma virus-associated oropharyngeal squamous cell carcinoma. Int J Clin Oncol 2023:10.1007/s10147-023-02336-8. [PMID: 37093464 PMCID: PMC10390603 DOI: 10.1007/s10147-023-02336-8] [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: 02/26/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023]
Abstract
Classical oropharyngeal squamous cell carcinoma (OPSCC) caused by alcohol consumption and smoking and HPV-associated OPSCC caused by human papillomavirus (HPV) infection have different etiologies, incidences, and prognoses. Therefore, the 8th American Joint committee on Cancer (AJCC) and Union for International Cancer Control (UICC) TNM classifications propose distinguishing HPV-associated OPSCC from classical OPSCC and classifying it as an independent disease. Therefore, this review provides an overview of HPV-associated OPSCC from the perspectives of epidemiology, carcinogenesis, development, diagnosis, treatment, and prevention. The incidence of HPV-associated OPSCC is increasing. Although HPV vaccination has been shown to be effective at reducing the incidence of cervical cancer, it is still unclear how it affects the incidence of HPV-associated OPSCC. Additionally, the prognosis of patients with HPV-associated OPSCC is extremely favorable compared to that of patients with classical OPSCC. Therefore, patients with HPV-associated OPSCC may undergo reduced-dose therapy, although attempts to reduce treatment intensity should be carefully planned to ensure they do not compromise oncological outcomes, and large-scale trials aimed at reducing treatment intensity are ongoing.
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Affiliation(s)
- Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan.
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan
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Syphilis resembling human papilloma virus associated oropharyngeal cancer: case report and literature review of recent incidence trends. J Laryngol Otol 2023; 137:200-204. [PMID: 35075989 DOI: 10.1017/s0022215121004540] [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: 11/06/2022]
Abstract
BACKGROUND The yearly incidence of syphilis has risen markedly in Japan and worldwide. There has also been an increased incidence of human papilloma virus associated oropharyngeal cancer, which presents with clinical features similar to those of syphilis. OBJECTIVE A case of syphilis with clinical manifestation resembling that of human papilloma virus associated oropharyngeal cancer is reported, along with a literature review of similar cases. METHODS Clinical case reports and review of previous literature. CONCLUSION Syphilis may cause irregular mucosal lesions of the oropharynx and cystic lymphadenopathy. It is difficult to diagnose syphilis only by examining pathological specimens, without clinical information such as Treponema pallidum antibody findings. It is necessary to correctly understand the characteristics of syphilis and human papilloma virus associated oropharyngeal cancer to ensure prompt diagnosis and treatment.
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10
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Itami J, Kobayashi K, Mori T, Honma Y, Kubo Y, Murakami N, Omura G, Okuma K, Inaba K, Takahashi K, Kashihara T, Shimizu Y, Takahashi A, Nakayama Y, Matsumoto F, Yoshimoto S, Igaki H. Non-Robustness of Ang’s Risk Classification in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma in Japanese Patients. Cancers (Basel) 2022; 14:cancers14102442. [PMID: 35626047 PMCID: PMC9139843 DOI: 10.3390/cancers14102442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Validity of the risk classification by Ang for human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remains to be studied in the patients treated by modalities other than chemoradiotherapy and in Japanese patients. Materials and Methods: Between 2010 and 2018, 122 patients with HPV-related OPSCC in stages III and IV by the TNM classification 7th edition (TNM-7) were treated curatively at a single institution in Japan. The median age was 62.7 years. Over 50% of the patients underwent surgery with or without adjuvant therapy. The influence of multiple factors on survival was analyzed. Results: The amount of smoking dichotomized at 10 pack-year, which was used in Ang’s risk classification, was not predictive of prognosis, and Ang’s risk classification was not significantly influential on prognosis in multivariate analysis. In the patients treated with definitive radiation therapy, Ang’s risk classification was not predictive of the prognosis in univariate analysis. The impact of smoking was significant only in the patients undergoing the definitive operation. Conclusions: Ang’s risk classification was not robust in predicting the prognosis of general Japanese HPV-related OPSCC patients. The amount of smoking might have different prognostic influences depending on the therapeutic method.
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Affiliation(s)
- Jun Itami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
- Shin-Matsudo Accuracy Radiation Therapy Center, Shin-Matsudo Central General Hospital, Chiba 270-0034, Japan
- Correspondence: ; Tel.: +81-47-345-1111
| | - Kenya Kobayashi
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Taisuke Mori
- Department of Pathology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Yoshitaka Honma
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Yuko Kubo
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan;
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Go Omura
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Kae Okuma
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Kana Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Yuri Shimizu
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Ayaka Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
| | - Fumihiko Matsumoto
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (K.K.); (G.O.); (F.M.); (S.Y.)
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; (N.M.); (K.O.); (K.I.); (K.T.); (T.K.); (Y.S.); (A.T.); (Y.N.); (H.I.)
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11
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Saito Y, Homma A, Kiyota N, Tahara M, Hanai N, Asakage T, Matsuura K, Ota I, Yokota T, Sano D, Kodaira T, Motegi A, Yasuda K, Takahashi S, Tanaka K, Onoe T, Okano S, Imamura Y, Ariizumi Y, Hayashi R. Human papillomavirus-related oropharyngeal carcinoma. Jpn J Clin Oncol 2022; 52:700-706. [PMID: 35383359 DOI: 10.1093/jjco/hyac049] [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: 09/28/2021] [Accepted: 03/19/2022] [Indexed: 11/13/2022] Open
Abstract
It was not until around 2000 that human papillomavirus-related oropharyngeal carcinoma was recognized as carcinoma with clinical presentations different from nonrelated head and neck carcinoma. Twenty years after and with the revision of the tumor-node-metastasis classification in 2017, various clinical trials focused on human papillomavirus-related oropharyngeal carcinoma to improve the prognosis and quality of life of patients with this disease. However, the incidence of human papillomavirus-related cancers is increasing, which is expected to be particularly prominent in Japan, where human papillomavirus vaccination is not widely available. In this review, we describe the current status of clinical trials (mainly focused on initial surgery and radiation dose reduction) for, primary and secondary prevention of, and the present status of human papillomavirus-related oropharyngeal carcinoma in Japan.
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Affiliation(s)
- Yuki Saito
- Department of Otolaryngology and Head and Neck Surgery, University of Tokyo, Tokyo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ichiro Ota
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
| | - Tomoya Yokota
- Divisions of Gastrointestinal Oncology, Shizuoka Cancer Center, Kashiwa, Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Kaoru Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - Takuma Onoe
- Division of Medical Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yoshinori Imamura
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Yosuke Ariizumi
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
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12
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Prophylactic contralateral neck dissection has no advantage in patients with early stage HPV-positive tonsil cancer. Acta Otolaryngol 2022; 142:345-349. [PMID: 35380481 DOI: 10.1080/00016489.2022.2053200] [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: 11/01/2022]
Abstract
BACKGROUND Patients with locally advanced HPV-positive tonsil cancer would benefit from prophylactic contralateral neck dissection (pCND). AIMS/OBJECTIVES The aim of this study was to analyze rates of contralateral lymph node metastases (LNM) and their prognostic effects on locally advanced HPV-positive tonsillar squamous cell carcinoma. MATERIALS AND METHODS Medical records of 54 patients who underwent upfront primary surgery and pCND were retrospectively reviewed. RESULTS Six (11.1%) patients had contralateral LNM in 54 locally advanced HPV-positive tonsil cancer. Of these, five patients had contralateral level II LNM and one patient had contralateral level II and III LNM. Contralateral LNM showed significant positive correlations with advanced T stage (p = .017) and the presence of extracapsular spread (p = .007). Contralateral lymph node metastasis had no significant association with five-year disease-specific survival. CONCLUSIONS AND SIGNIFICANCE This study demonstrated no advantage in performing pCND in early stage HPV-positive tonsil cancer.
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13
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Kawakita D, Oze I, Iwasaki S, Matsuda T, Matsuo K, Ito H. Trends in the incidence of head and neck cancer by subsite between 1993 and 2015 in Japan. Cancer Med 2022; 11:1553-1560. [PMID: 35029329 PMCID: PMC8921930 DOI: 10.1002/cam4.4539] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/05/2021] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Daisuke Kawakita
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Department of Otorhinolaryngology, Head and Neck Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Tomohiro Matsuda
- Division of International Collaborative Research Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Department of Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Hidemi Ito
- Division of Cancer Information and Control Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Division of Descriptive Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
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14
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A risk factor for newly diagnosed secondary cancer in patients with early-stage laryngeal, oropharyngeal, or hypopharyngeal cancer: sub-analysis of a prospective observation study. Int J Clin Oncol 2021; 27:488-494. [PMID: 34787745 DOI: 10.1007/s10147-021-02080-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND We previously identified hypopharyngeal cancer as an independent risk factor for the incidence of newly diagnosed secondary cancers after the treatment of early-stage laryngeal, oropharyngeal, and hypopharyngeal cancers. We subsequently used a different patient cohort to validate the usefulness of this factor during the follow-up period in these patients. METHODS Patients who underwent transoral surgery (TOS) as a definitive treatment between April 1, 2016, and September 30, 2020, were included. The incidence of secondary cancer was evaluated in hypopharyngeal and other cancers. Overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS) outcomes were evaluated. Statistical analyses based on the risk factors were also performed. RESULTS Incidence of new secondary cancer was 30% in hypopharyngeal cancer patients as compared to 11% in other cancer patients, and the risk was 3.60-fold (95% confidence interval 1.07-12.10) higher after definitive treatment for initial head and neck cancers. The 3-year OS, RFS, and DFS rates were 98%, 86%, and 67%, respectively. CONCLUSIONS Among patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal squamous cell carcinoma, who were initially treated with TOS, hypopharyngeal cancer patients had a higher risk of newly diagnosed secondary cancers as observed during the follow-up period.
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15
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Inoue M, Shimizu Y, Taniguchi M, Kimura Y, Furuhashi H, Dobashi A, Ikeya T, Goda K, Kato M, Kato M, Sakamoto N, Watanabe A. Evaluation of the risk of metachronous multiple squamous cell carcinoma of the head and neck after transoral surgery based on the genetic polymorphisms of alcohol dehydrogenase 1B and aldehyde dehydrogenase 2. Carcinogenesis 2021; 42:1232-1238. [PMID: 34546328 DOI: 10.1093/carcin/bgab085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/08/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023] Open
Abstract
Patients with superficial head and neck squamous cell carcinoma (HNSCC) can be completely treated by techniques of transoral surgery (TOS). The aim of this study was to evaluate the risk of metachronous multiple HNSCC arising after TOS based on alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2). We registered patients who underwent TOS for superficial HNSCC. Buccal cell samples were obtained by using a cotton swab to examine two single nucleotide polymorphisms in ADH1B and ALDH2 genotyping. We used Cox proportional hazards models to examine the risk of metachronous HNSCC. A total of 198 patients who underwent TOS for HNSCC were evaluated. In multivariate analysis, risks for second HNSCC were ADH1B*1/*1 [hazard ratio (HR), 1.88; 95% confidence interval (CI), 1.11-3.19; P = 0.02], ALDH2*1/*2 (HR, 2.11; 95% CI, 1.00-5.16; P = 0.048) and alcohol consumption before TOS (HR, 1.17; 95% CI, 1.06-1.27; P = 0.01). The 5-year incidence rates of second primary HNSCC in the temperance group and the non-temperance group were 20.8 and 46.5%, respectively (HR, 0.54; 95% CI, 0.31-0.92; P = 0.02). Cumulative development rates of third HNSCC in the temperance group and non-temperance group at 10 years were 11.3 and 36.1%, respectively (HR, 0.19; 95% CI, 0.03-0.65; P = 0.006). ADH1B*1/*1, ALDH2*1/*2 and moderate or heavy alcohol consumption before treatment are independent risk factors of metachronous HNSCC. Since it was shown that temperance decreased the incidences of second and third metachronous HNSCC, advice to discontinue alcohol drinking is necessary.
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Affiliation(s)
- Masaki Inoue
- Department of Gastroenterology and Hepatology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yuichi Shimizu
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Masanobu Taniguchi
- Department of Otolaryngology Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Yuki Kimura
- Department of Otolaryngology Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Hiroto Furuhashi
- Department of Endoscopy, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Akira Dobashi
- Department of Endoscopy, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Takashi Ikeya
- Department of Gastroenterology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan
| | - Kenichi Goda
- Department of Gastroenterology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan
| | - Masayuki Kato
- Department of Endoscopy, The Jikei University Katsushika Medical Center, Katsushika-ku, Tokyo, Japan
| | - Mototsugu Kato
- Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine and Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akihito Watanabe
- Department of Otolaryngology Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Hokkaido, Japan
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16
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Sato MP, Otsuki N, Kitano M, Doi K. Incidental p16-positive oropharyngeal carcinoma found during tonsillectomy for palmoplantar pustulosis. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2021. [DOI: 10.1080/23772484.2021.1935264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Mitsuo P. Sato
- Department of Otorhinolaryngology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Naoki Otsuki
- Department of Otorhinolaryngology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Mutsukazu Kitano
- Department of Otorhinolaryngology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Katsumi Doi
- Department of Otorhinolaryngology, Kindai University Faculty of Medicine, Osakasayama, Japan
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17
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Shih HS, Jhou HJ, Ou YH, Liu YT, Kor CT, Chen AWG, Chen MK. The Efficacy and Adverse Events in Patients with Head and Neck Cancer Following Radiotherapy Combined with S-1 Therapy: A Meta-Analysis. Cancers (Basel) 2021; 13:cancers13122971. [PMID: 34199326 PMCID: PMC8231857 DOI: 10.3390/cancers13122971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022] Open
Abstract
This meta-analysis was conducted to assess the efficacy and adverse events associated with S-1 chemotherapy combined with radiotherapy for patients with head and neck cancer. The PubMed, Embase, and Cochrane Library databases were searched up to 10 February 2021. Eligible studies included clinical trials using S-1 chemotherapy combined with radiotherapy for head and neck cancer patients that measured tumor response, local control rate, overall survival, and grade 3/4 adverse events. A meta-analysis was performed using a random effects model. Twelve trials involving 378 patients met the selection criteria. The objective response and clinical benefit rate (complete/partial response and stable disease) of S-1 chemotherapy with radiotherapy were 86.3% (95% confidence interval (CI), 60.3-96.3) and 88.3% (95% CI, 70.1-96.1), respectively. The median 3-year local control rate, 3-year overall survival rate, and grade 3/4 adverse event rate were 84.0% (95% CI, 71.4-91.7), 69.6% (95% CI, 54.9-81.1), and 42.0% (95% CI, 36.2-48.0), respectively. S-1 combined with radiotherapy for patients with head and neck squamous cell carcinoma results in a good tumor response, favorable survival rate, and low toxicity. A prospective randomized, double-blind trial is required to assess the efficacy and safety of S-1 combined with radiotherapy to treat HNSCC.
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Affiliation(s)
- Hung-Sheng Shih
- Division of General Practice, Department of Medical Education, Changhua Christian Hospital, Changhua 500, Taiwan; or
| | - Hong-Jie Jhou
- Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan or (H.-J.J.); or (Y.-H.O.)
| | - Yang-Hao Ou
- Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan or (H.-J.J.); or (Y.-H.O.)
| | - Yen-Tze Liu
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan;
- Department of Family Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
- Department of Holistic Wellness, Mingdao University, Changhua 500, Taiwan
- Oral Cancer Research Center, Changhua Christian Hospital, Changhua 500, Taiwan
- Big Data Center, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Chew-Teng Kor
- Big Data Center, Changhua Christian Hospital, Changhua 500, Taiwan;
- Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua 500, Taiwan
| | - Andy Wei-Ge Chen
- Department of Otolaryngology-Head & Neck Surgery, Changhua Christian Hospital, Changhua 500, Taiwan
- Correspondence: (A.W.-G.C.); (M.-K.C.)
| | - Mu-Kuan Chen
- Department of Otolaryngology-Head & Neck Surgery, Changhua Christian Hospital, Changhua 500, Taiwan
- Correspondence: (A.W.-G.C.); (M.-K.C.)
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18
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Girardi FM, Wagner VP, Martins MD, Abentroth AL, Hauth LA. Prevalence of p16 expression in oropharyngeal squamous cell carcinoma in southern Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:681-691. [PMID: 32981865 DOI: 10.1016/j.oooo.2020.08.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/16/2020] [Accepted: 08/16/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Our aim was to evaluate the prevalence of human papillomavirus (HPV)-positive tumors in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) at a single center in southern Brazil and determine the short-term prognostic factors in this sample. STUDY DESIGN Ninety-one consecutive patients with newly diagnosed primary OPSCC between January 2017 and December 2019 were retrospectively included. Demographic, clinical, pathologic, and survival data were collected. HPV status was determined by using p16 immunohistochemistry. RESULTS The overall prevalence of HPV-positive (HPV+) OPSCC was 20.9%. Patients with HPV+ tumors presented a nodal metastasis as the first clinical sign (P = .02); reported less alcohol (P < .001) and tobacco use (P < .001); exhibited lower tumor stages (P < .001) and higher microscopic grades (P = .01); and had higher chances of having resectable tumors (P = .008). p16-negative status (P = .01); unresectable/inoperable tumors (P < .001); presence of nodal metastasis (P = .005); and higher American Joint Committee on Cancer (AJCC) stage (P = .002) were significantly associated with worse disease-specific survival. CONCLUSIONS The prevalence of HPV+ OPSCC in southern Brazil is relatively low, and p16-positive status was associated with Better prognosis. Higher AJCC stage, nodal metastasis, and unresectability/inoperability were associated with the highest hazard ratios for death resulting from OPSCC.
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Affiliation(s)
| | - Vivian P Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Medicine, Porto Alegre Clinics Hospital (HCPA/UFRGS), Porto Alegre, RS, Brazil
| | | | - Luiz Alberto Hauth
- Integrated Oncology Center of Ana Nery Hospital, Santa Cruz do Sul, RS, Brazil
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19
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Saito Y, Hayashi R, Iida Y, Mizumachi T, Fujii T, Matsumoto F, Beppu T, Yoshida M, Shinomiya H, Kamiyama R, Kitano M, Yokoshima K, Fujimoto Y, Hama T, Yamashita T, Okami K, Miura K, Fujisawa T, Sano D, Kato H, Minami S, Sugasawa M, Masuda M, Ota I, Iwae S, Kawata R, Monden N, Imai T, Asakage T, Okada M, Yoshikawa T, Tanioka K, Kitayama M, Doi M, Fujii S, Fujii M, Oridate N, Nakamizo M, Yoshimoto S, Homma A, Nibu KI, Yane K. Optimization of therapeutic strategy for p16-positive oropharyngeal squamous cell carcinoma: Multi-institutional observational study based on the national Head and Neck Cancer Registry of Japan. Cancer 2020; 126:4177-4187. [PMID: 32648953 DOI: 10.1002/cncr.33062] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although the American Joint Committee on Cancer TNM classification has been amended to include human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) as an independent entity, to the authors' knowledge the optimized de-escalating treatment modality has not been established to date. METHODS The authors conducted a retrospective, nationwide, observational study in patients with HPV-related OPSCC who were treated from 2011 to 2014 in Japan to determine the best treatment modality. RESULTS A total of 688 patients who were newly diagnosed with HPV-related OPSCC who were treated with curative intent at 35 institutions and had coherent clinical information and follow-up data available were included in the current study. In patients with T1-T2N0 disease (79 patients), both the 3-year recurrence-free survival and overall survival (OS) rates were 100% in the group treated with radiotherapy (RT) as well as the group receiving concurrent chemoradiotherapy (CCRT). The 3-year OS rates were 94.4% (for patients with T1N0 disease) and 92.9% (for patients with T2N0 disease) among the patients treated with upfront surgery. In patients with stage I to stage II HPV-related OPSCC, the 5-year recurrence-free survival and OS rates were 91.4% and 92%, respectively, in the patients treated with CCRT with relatively high-dose cisplatin (≥160 mg/m2 ; 114 patients) and 74.3% and 69.5%, respectively, in the patients treated with low-dose cisplatin (<160 mg/m2 ; 17 patients). CONCLUSIONS Despite it being a retrospective observational trial with a lack of information regarding toxicity and morbidity, the results of the current study demonstrated that patients with T1-T2N0 HPV-related OPSCC could be treated with RT alone because of the equivalent outcomes of RT and CCRT, and patients with stage I to stage II HPV-related OPSCC other than those with T1-T2N0 disease could be treated with CCRT with cisplatin at a dose of ≥160 mg/m2 .
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Affiliation(s)
- Yuki Saito
- Department of Otolaryngology, Head and Neck Surgery, University of Tokyo, Tokyo, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Yoshiyuki Iida
- Department of Head and Neck Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Takatsugu Mizumachi
- Department of Otorhinolaryngology, Hokkaido University Hospital, Hokkaido, Japan
| | - Takashi Fujii
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Fumihiko Matsumoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Beppu
- Department of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan
| | - Masafumi Yoshida
- Department of Otolaryngology, Head and Neck Surgery, University of Tokyo, Tokyo, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Hyogo, Japan
| | - Ryosuke Kamiyama
- Department of Head and Neck Surgery, Cancer Institute Hospital, Tokyo, Japan
| | - Mutsukazu Kitano
- Department of Otolaryngology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuhiko Yokoshima
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takanori Hama
- Department of Otolaryngology, Jikei University Hospital, Tokyo, Japan
| | - Taku Yamashita
- Department of Otolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kenji Okami
- Department of Otolaryngology, Tokai University Hospital, Kanagawa, Japan
| | - Kouki Miura
- Department of Head and Neck Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Takuo Fujisawa
- Department of Otolaryngology, Kansai Medical University, Osaka, Japan
| | - Daisuke Sano
- Department of Otolaryngology-Head and Neck Surgery, Yokohama City University, School of Medicine, Kanagawa, Japan
| | - Hisayuki Kato
- Department of Otolaryngology & Head and Neck Surgery, Fujita Health University School of Medicine, Aichi, Japan
| | - Shujiro Minami
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Masashi Sugasawa
- Department of Head and Neck Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Muneyuki Masuda
- Department of Head and Neck Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Ichiro Ota
- Department of Otolaryngology, Nara Medical University Hospital, Nara, Japan
| | - Shigemichi Iwae
- Department of Head and Neck Surgery, Hyogo Cancer Center, Hyogo, Japan
| | - Ryo Kawata
- Department of Otolaryngology, Osaka Medical College Hospital, Osaka, Japan
| | - Nobuya Monden
- Department of Head and Neck Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Takayuki Imai
- Department of Head and Neck Surgery, Miyagi Cancer Center, Miyagi, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Masafumi Okada
- University Hospital Medical Information Network, Tokyo, Japan
| | - Takanori Yoshikawa
- Data Center Department, Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan
| | - Kensuke Tanioka
- Faculty of life and biomedical sciences, Doshisha Univeristy, Kyoto, Japan
| | - Megumi Kitayama
- Data Center Department, Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan
| | - Mariko Doi
- Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Chiba, Japan.,Department of Molecular Pathology, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Masato Fujii
- Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Nobuhiko Oridate
- Department of Otolaryngology-Head and Neck Surgery, Yokohama City University, School of Medicine, Kanagawa, Japan
| | - Munenaga Nakamizo
- Department of Otorhinolaryngology, Nippon Medical School Hospital, Tokyo, Japan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiro Homma
- Department of Otorhinolaryngology, Hokkaido University Hospital, Hokkaido, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University School of Medicine, Hyogo, Japan
| | - Katsunari Yane
- Department of Otorhinolaryngology, Kindai University Nara Hospital, Nara, Japan
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20
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Cho H, Kishikawa T, Tokita Y, Suzuki M, Takemoto N, Hanamoto A, Fukusumi T, Yamamoto M, Fujii M, Ohno Y, Inohara H. Prevalence of human papillomavirus in oral gargles and tonsillar washings. Oral Oncol 2020; 105:104669. [PMID: 32259682 DOI: 10.1016/j.oraloncology.2020.104669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) infection drives carcinogenesis in the oropharynx. No standard sampling or HPV detection methods for evaluating oropharyngeal HPV infection exist. The prevalence of oral HPV infection in Japan is unknown. MATERIALS AND METHODS We examined 435 healthy Japanese individuals to address whether adding tonsillar washing to oral gargling would improve HPV detection. We compared HPV assessment using GENOSEARCH HPV31 versus nested PCR and direct sequencing. Associations between HPV infection and demographic and behavioral characteristics were examined. RESULTS Most participants who were HPV-positive based on oral gargles were also HPV-positive based on tonsillar washings: 11 (64.7%) of 17 on nested PCR and 12 (70.6%) of 17 on GENOSEARCH HPV31. Although HPV infection was more prevalent in oral gargles followed by tonsillar washings than in oral gargles alone, the difference was not statistically significant (nested PCR, 4.8% vs. 3.9%, P = 0.46; GENOSEARCH HPV31, 5.3% vs. 3.9%, P = 0.33). The overall agreement between nested PCR and GENOSEARCH HPV31 was 98.6%, with 76.0% positive agreement. The overall prevalence of oral HPV infection in Japan was 5.7% (95% confidence interval, 3.9-8.3%). Men had a significantly higher prevalence of oral HPV infection than women (8.3% vs. 2.6%, P = 0.02). Infection increased with number of lifetime sexual partners (P < 0.001 for trend). CONCLUSION The oropharynx is probably the major source of HPV-infected cells in oral gargles. Oral gargling could be a standard sampling method for evaluating oropharyngeal HPV infection. GENOSEARCH HPV31 could be an option for oral HPV detection.
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Affiliation(s)
- H Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Kishikawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Tokita
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan; Department of Nursing, Kyoto Tachibana University, Kyoto, Japan.
| | - M Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - N Takemoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - A Hanamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Fukusumi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Fujii
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Ohno
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - H Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
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21
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Kimura E, Araki K, Tomifuji M, Tanaka Y, Uno K, Yamashita T, Shiotani A. Value of transoral surgery for human papillomavirus-mediated oropharyngeal cancer: validation of a new staging system in Japanese patients. J Int Med Res 2019; 47:5048-5059. [PMID: 31516052 PMCID: PMC6833394 DOI: 10.1177/0300060519866594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective This study aimed to validate new staging of Japanese patients with human papillomavirus-mediated oropharyngeal cancer (HPV+-OPC) and the effectiveness of transoral surgery. Methods Fifty-three patients with HPV+-OPC were classified according to the seventh and eighth editions of the American Joint Committee on Cancer (AJCC) staging, along with assessment of prognosis, smoking and alcohol status, and treatment outcome. Transoral videolaryngoscopic surgery (TOVS) was performed as transoral surgery. Results The 5-year overall survival (OS) rate was 77.3% in all patients. Five-year OS rates of seventh edition staging were as follows: II, 100%; III, 100%; IVa, 75.9%; and IVb and IVc, 0%. Five-year OS rates of the eighth edition clinical staging were as follows: I, 89.3%; II, 88.9%; III, 46.3%; and IV, 0%. In non-smoking and smoking patients with HPV+-OPC, the 5-year OS rates were 90.9% and 70.7%, respectively. TOVS was used for treating 20 smokers with HPV+-OPC (5-year OS: 85.7%), while 12 were treated with chemoradiotherapy (5-year OS: 75.0%). Conclusions The eighth edition of the AJCC determines the prognosis of HPV+-OPC more accurately than the seventh edition in clinical staging. Smokers with HPV+-OPC have a poor prognosis, but TOVS might improve the prognosis.
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Affiliation(s)
- Eiko Kimura
- Department of Otolaryngology - Head and Neck Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Koji Araki
- Department of Otolaryngology - Head and Neck Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Masayuki Tomifuji
- Department of Otolaryngology - Head and Neck Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Yuya Tanaka
- Department of Otolaryngology - Head and Neck Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Kosuke Uno
- Department of Otolaryngology - Head and Neck Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Taku Yamashita
- Department of Otolaryngology - Head and Neck Surgery, Kitasato University, Sagamihara, Japan
| | - Akihiro Shiotani
- Department of Otolaryngology - Head and Neck Surgery, National Defense Medical College, Tokorozawa, Japan
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22
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Kano M, Kondo S, Wakisaka N, Wakae K, Aga M, Moriyama-Kita M, Ishikawa K, Ueno T, Nakanishi Y, Hatano M, Endo K, Sugimoto H, Kitamura K, Muramatsu M, Yoshizaki T. Expression of estrogen receptor alpha is associated with pathogenesis and prognosis of human papillomavirus-positive oropharyngeal cancer. Int J Cancer 2019; 145:1547-1557. [PMID: 31228270 DOI: 10.1002/ijc.32500] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/29/2019] [Indexed: 12/13/2022]
Abstract
Human papillomavirus (HPV) has been identified as a causative agent of cervical cancer and oropharyngeal cancer (OPC). Intriguingly, estrogen and HPV were shown to play synergistic roles in cervical carcinogenesis. We recently demonstrated that the apolipoprotein B mRNA-editing catalytic polypeptide 3 (APOBEC3, A3) family, which is inducible by estrogen, could lead to HPV DNA hypermutation and cause viral DNA integration. In the present study, we examined the relationships between estrogen-estrogen receptor α (ERα) and A3s in HPV-positive OPC. ERα expression was associated with HPV positivity in OPC biopsy samples using immunohistochemical analysis and reverse-transcription quantitative polymerase chain reaction. In addition, ERα was significantly associated with improved overall survival in HPV-positive OPC (hazard ratio, 0.26; p = 0.029). APOBEC3A (A3A) mRNA was induced by estrogen in HPV and ERα-positive OPC cells. Furthermore, A3A mRNA and protein expression were significantly higher in ERα-positive cases than in ERα-negative ones, among HPV-positive biopsy samples (p = 0.037 and 0.047). These findings suggest that A3A is associated with a good prognosis in ERα-positive OPC, and indicate the prognostic significance of ERα in HPV-positive OPC. This is the first study to demonstrate the prognostic role of ERα in HPV-positive OPC.
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Affiliation(s)
- Makoto Kano
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.,Department of Otolaryngology, National Hospital Organization Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | - Satoru Kondo
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Naohiro Wakisaka
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kosho Wakae
- Department of Molecular Genetics, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.,Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Mituharu Aga
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Makiko Moriyama-Kita
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kazuya Ishikawa
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takayoshi Ueno
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Yosuke Nakanishi
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Miyako Hatano
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kazuhira Endo
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hisashi Sugimoto
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kouichi Kitamura
- Department of Molecular Genetics, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Masamichi Muramatsu
- Department of Molecular Genetics, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.,Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomokazu Yoshizaki
- Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan
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23
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Okano S, Enokida T, Onoe T, Ota Y, Motegi A, Zenda S, Akimoto T, Tahara M. Induction TPF chemotherapy followed by CRT with fractionated administration of cisplatin in patients with unresectable locally advanced head and neck cancer. Int J Clin Oncol 2019; 24:789-797. [PMID: 30796560 DOI: 10.1007/s10147-019-01418-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND In treatment of locally advanced squamous cell carcinoma of the head and neck (SCCHN), the use of docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by high-dose cisplatin chemoradiotherapy (CRT) carries concerns over toxicity. We evaluated the feasibility of TPF as induction chemotherapy (IC) to Japanese patients and the tolerability of CRT with fractionated administration of cisplatin after IC. METHODS Patients with unresectable stage III, IV SCCHN received IC followed by CRT. IC consisted of three 3-week cycles of docetaxel 70-75 mg/m2 on day 1, cisplatin 70-75 mg/m2 on day 1, and 5-fluorouracil 750 mg/m2 on days 1-5. Patients subsequently received IMRT concomitant with fractionated administration of cisplatin (20 mg/m2) on days 1-4, repeated every 3 weeks. The primary endpoint was completion of the three cycles of IC. RESULTS Forty-eight patients were enrolled. The IC treatment completion rate was 85%. Grade 3-4 toxicities of TPF were neutropenia (79%) and febrile neutropenia (15%). Thirty-eight patients (79%) achieved a response after IC. Forty patients subsequently underwent CRT. Thirty-three patients (83%) completed the planned cycles of fractionated administration of cisplatin, but seven (18%) did not. Grade 3-4 toxicities during CRT were neutropenia (23%), mucositis (53%), and dysphagia (33%). With a median follow-up of 36.1 months, 3-year overall survival was 65%. CONCLUSION TPF IC is feasible and CRT with fractionated administration of cisplatin after IC is tolerable. IC followed by CRT appears to be a useful and safe sequential treatment. (Trial registration no. UMIN000024686).
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Affiliation(s)
- Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tomohiro Enokida
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takuma Onoe
- Department of Medical Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Yosuke Ota
- Department of Radiation Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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24
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Iwatsubo T, Ishihara R, Morishima T, Maekawa A, Nakagawa K, Arao M, Ohmori M, Iwagami H, Matsuno K, Inoue S, Nakahira H, Matsuura N, Shichijo S, Kanesaka T, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Miyashiro I, Higuchi K, Fujii T. Impact of age at diagnosis of head and neck cancer on incidence of metachronous cancer. BMC Cancer 2019; 19:3. [PMID: 30606157 PMCID: PMC6318848 DOI: 10.1186/s12885-018-5231-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
Background Metachronous cancer in patients with head and neck cancer (HNC) is common and is associated with a poor prognosis. We aimed to evaluate the incidence of metachronous cancer at different sites according to age at diagnosis of index HNC. Methods We collected data on 2011 patients with oral cancer, oropharynx cancer, hypopharyngeal cancer, and laryngeal cancer as index cancers using the Osaka International Cancer Institute Cancer Registry database between 2005 and 2016. Among these, we analyzed 1953 patients after excluding 5 patients who were not followed-up and 53 patients with simultaneous multiple index cancers. We evaluated the cumulative incidence of metachronous cancer in the esophagus, lung, and other sites according to age at diagnosis of the index HNC using the Kaplan–Meier method. Multivariate logistic regression analysis was performed to identify factors that influenced the incidence of metachronous cancers following HNC. Results The cumulative incidence of metachronous esophageal cancer in young patients (< 65 years) was significantly higher than that in old patients (≥ 65 years) (12.1% vs 8.5% at 5 years, and 16.5% vs 11.2% at 10 years; p = 0.015). On the other hand, the cumulative incidence of the other cancers in young patients was significantly lower than that in old patients (7.8% vs 12.2% at 5 years, and 13.9% vs 15.3% at 10 years; p = 0.017). The cumulative incidence of lung cancer was not significance according to age at diagnosis of the index HNC. In the multivariate analysis, histological type (squamous cell carcinoma) and lesion location (hypopharynx and larynx) were independently associated with metachronous cancers. Moreover, age at diagnosis of the index HNC (< 65 years), histological type (squamous cell carcinoma) and lesion location (hypopharynx) were significant predictors of metachronous esophageal cancer incidence and lesion location (hypopharynx) was a significant predictor of metachronous lung cancer incidence. Conclusion Risk stratification of metachronous cancers with age and other predictors may help to properly manage patients with HNC. Trial registration The present study is a non-intervention trial.
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Affiliation(s)
- Taro Iwatsubo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.,Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
| | - Toshitaka Morishima
- Department of Cancer Strategy, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Maekawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kentaro Nakagawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masamichi Arao
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masayasu Ohmori
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hiroyoshi Iwagami
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kenshi Matsuno
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Shuntaro Inoue
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hiroko Nakahira
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Satoki Shichijo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Sachiko Yamamoto
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Isao Miyashiro
- Department of Cancer Strategy, Osaka International Cancer Institute, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Takashi Fujii
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
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25
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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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Elicin O, Broglie MA, Fankhauser N, Stoeckli SJ, Pasche P, Reinhard A, Bongiovanni M, Huber GF, Morand GB, Soltermann A, Arnold A, Dettmer MS, Arnoux A, Stauffer E, Espeli V, Martucci F, Aebersold DM, Giger R. Comparison of contemporary staging systems for oropharynx cancer in a surgically treated multi‐institutional cohort. Head Neck 2018; 41:1395-1402. [DOI: 10.1002/hed.25574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 11/30/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University HospitalUniversity of Bern Bern Switzerland
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Niklaus Fankhauser
- CTU Bern, and Institute of Social and Preventive Medicine (ISPM)University of Bern Bern Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
| | - Philippe Pasche
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of Lausanne Lausanne Switzerland
| | - Antoine Reinhard
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of Lausanne Lausanne Switzerland
| | - Massimo Bongiovanni
- Service of Clinical PathologyLausanne University Hospital, Institute of Pathology Lausanne Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Alex Soltermann
- Institute of Surgical PathologyUniversity Hospital of Zurich Zurich Switzerland
| | - Andreas Arnold
- Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, Bern University Hospital Bern Switzerland
| | | | - André Arnoux
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital Aarau Aarau Switzerland
| | | | - Vittoria Espeli
- Oncology Institute of Southern Switzerland (IOSI) Bellinzona Switzerland
| | - Francesco Martucci
- Department of RadiooncologyOncology Institute of Southern Switzerland (IOSI) Bellinzona Switzerland
| | - Daniel M. Aebersold
- Department of Radiation Oncology, Inselspital, Bern University HospitalUniversity of Bern Bern Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck SurgeryInselspital, Bern University Hospital Bern Switzerland
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Kida K, Terada T, Uwa N, Omori Y, Fujii T, Tomita Y, Tsuzuki K, Nishikawa H, Sakagami M. Relationship Between p16 Expression and Prognosis in Patients with Oropharyngeal Cancer Undergoing Surgery. In Vivo 2018; 32:927-935. [PMID: 29936482 DOI: 10.21873/invivo.11331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Prognostic impact of p16 expression in patients with oropharyngeal squamous cell carcinoma (OSCC) undergoing surgery is not fully examined. The aim of this study was to clarify these issues. PATIENTS AND METHODS Sixty-four OSCC subjects were analyzed. Immuno-histochemical staining of p16, a surrogate marker for human papillomavirus (HPV), was performed histopathologically. Data were retrospectively analyzed according to p16 positivity and factors linked to prognosis were also analyzed. RESULTS No significant difference was observed in the prognosis between the p16-positive group (n=28) and the p16-negative group (n=36). In patients undergoing post-operative radiation, the p16-positive group (n=18) had a significantly better prognosis than the p16-negative group (n=6). On multivariate analysis, transoral surgery was a significant predictor of overall survival (p=0.0173). CONCLUSION Prognostic impact of p16 can be emphasized in a subgroup of OSCC patients undergoing surgery. Surgery with sufficient surgical margin may be chosen as the first treatment for HPV-negative OSCC in some cases.
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Affiliation(s)
- Kota Kida
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Tomonori Terada
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Nobuhiro Uwa
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Yoshihiko Omori
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Takashi Fujii
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Yasuhiko Tomita
- Department of Pathology Diagnosis, International University of Health and Welfare, Tokyo, Japan
| | - Kenzo Tsuzuki
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Hiroki Nishikawa
- Center for Clinical Research and Education, Hyogo College of Medicine, Hyogo, Japan
| | - Masafumi Sakagami
- Department of Otolaryngology-Head and Neck Surgery, Hyogo College of Medicine, Hyogo, Japan
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The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan: A single-centre study. Auris Nasus Larynx 2018; 45:558-565. [DOI: 10.1016/j.anl.2017.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/03/2017] [Accepted: 07/11/2017] [Indexed: 11/24/2022]
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Gipson BJ, Robbins HA, Fakhry C, D'Souza G. Sensitivity and specificity of oral HPV detection for HPV-positive head and neck cancer. Oral Oncol 2018; 77:52-56. [PMID: 29362127 PMCID: PMC5788034 DOI: 10.1016/j.oraloncology.2017.12.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/09/2017] [Accepted: 12/13/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The incidence of HPV-related head and neck squamous cell carcinoma (HPV-HNSCC) is increasing. Oral samples are easy and non-invasive to collect, but the diagnostic accuracy of oral HPV detection methods for classifying HPV-positive HNSCC tumors has not been well explored. METHODS In a systematic review, we identified eight studies of HNSCC patients meeting our eligibility criteria of having: (1) HPV detection in oral rinse or oral swab samples, (2) tumor HPV or p16 testing, (3) a publication date within the last 10 years (January 2007-May 2017, as laboratory methods change), and (4) at least 15 HNSCC cases. Data were abstracted from each study and a meta-analysis performed to calculate sensitivity and specificity. RESULTS Eight articles meeting inclusion criteria were identified. Among people diagnosed with HNSCC, oral HPV detection has good specificity (92%, 95% CI = 82-97%) and moderate sensitivity (72%, 95% CI = 45-89%) for HPV-positive HNSCC tumor. Results were similar when restricted to studies with only oropharyngeal cancer cases, with oral rinse samples, or testing for HPV16 DNA (instead of any oncogenic HPV) in the oral samples. DISCUSSION Among those who already have HNSCC, oral HPV detection has few false-positives but may miss one-half to one-quarter of HPV-related cases (false-negatives). Given these findings in cancer patients, the utility of oral rinses and swabs as screening tests for HPV-HNSCC among healthy populations is probably limited.
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Affiliation(s)
- Brooke J Gipson
- Department of Global and Community Health, George Mason University College of Health and Human Services, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
| | - Hilary A Robbins
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, United States
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States.
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Misawa K, Mochizuki D, Imai A, Mima M, Misawa Y, Mineta H. Analysis of Site-Specific Methylation of Tumor-Related Genes in Head and Neck Cancer: Potential Utility as Biomarkers for Prognosis. Cancers (Basel) 2018; 10:cancers10010027. [PMID: 29361757 PMCID: PMC5789377 DOI: 10.3390/cancers10010027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 12/14/2022] Open
Abstract
Clarifying the epigenetic regulation of tumor-related genes (TRGs) can provide insights into the mechanisms of tumorigenesis and the risk for disease recurrence in HPV-negative head and neck cancers, originating in the hypopharynx, larynx, and oral cavity. We analyzed the methylation status of the promoters of 30 TRGs in 178 HPV-negative head and neck cancer patients using a quantitative methylation-specific PCR. Promoter methylation was correlated with various clinical characteristics and patient survival. The mean number of methylated TRGs was 14.2 (range, 2-25). In the multivariate Cox proportional hazards analysis, the methylation of COL1A2 and VEGFR1 was associated with poor survival for hypopharyngeal cancer, with hazard ratios: 3.19; p = 0.009 and 3.07; p = 0.014, respectively. The methylation of p16 and COL1A2 were independent prognostic factors for poor survival in laryngeal cancer (hazard ratio: 4.55; p = 0.013 and 3.12; p = 0.035, respectively). In patients with oral cancer, the methylation of TAC1 and SSTR1 best correlated with poor survival (hazard ratio: 4.29; p = 0.005 and 5.38; p = 0.029, respectively). Our findings suggest that methylation status of TRGs could serve as important site-specific biomarkers for prediction of clinical outcomes in patients with HPV-negative head and neck cancer.
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Affiliation(s)
- Kiyoshi Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan.
| | - Daiki Mochizuki
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan.
| | - Atsushi Imai
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan.
| | - Masato Mima
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan.
| | - Yuki Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan.
| | - Hiroyuki Mineta
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan.
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Shinomiya H, Shinomiya H, Kubo M, Saito Y, Yoshida M, Ando M, Teshima M, Otsuki N, Kiyota N, Sasaki R, Nibu KI. Prognostic value of ALDH2 polymorphism for patients with oropharyngeal cancer in a Japanese population. PLoS One 2017; 12:e0187992. [PMID: 29206831 PMCID: PMC5716598 DOI: 10.1371/journal.pone.0187992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/30/2017] [Indexed: 01/02/2023] Open
Abstract
Background Half of Japanese possess a polymorphism of aldehyde dehydrogenase 2(ALDH2), while few white individuals possess this mutation. The purpose of this study was to investigate the possibility of ALDH2 polymorphism as a prognostic factor for oropharyngeal cancer (OPC) among Japanese population. Methods We analyzed 82 Japanese patients with OPC treated between 2006 and 2011. The median observation period was 50 months. P16-staining and ALDH2 polymorphisms were investigated. To examine the frequencies of second primary pharyngeal and esophageal cancers (SPPEC),37 Japanese patients with OPC treated at Tokyo University Hospital were included for statistical analysis. Results Statistically significant differences were noted in OS among sex, age, N classification, and p16 (p = 0.045, 0.024, 0.020, 0.007, respectively). In addition, OS and DSS rates of the patients with heterozygous ALDH2 tended to be worse than those of the patients with homozygous ALDH2 (p = 0.21, 0.086, respectively). Of note, OS and DSS of the patients with p16-negative OPC and heterozygous ALDH2 was significant poorer than those of the patients with p16-positive OPC (p = 0.002, 0.006, respectively), while there was no significant difference in OS and DSS between patients with p16-positive OPC and patients with p16-negative OPC and homozygous ALDH2. Conclusions ALDH2 polymorphism might be a promising prognostic factor for Japanese patients with p16-negative OPC.
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Affiliation(s)
- Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- * E-mail: (HS); (KIN)
| | - Hitomi Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mie Kubo
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuki Saito
- Department of Head and Neck Surgery-Otolaryngology, University of Tokyo, Tokyo, Japan
| | - Masafumi Yoshida
- Department of Head and Neck Surgery-Otolaryngology, University of Tokyo, Tokyo, Japan
| | - Mizuo Ando
- Department of Head and Neck Surgery-Otolaryngology, University of Tokyo, Tokyo, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- * E-mail: (HS); (KIN)
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Haeggblom L, Ramqvist T, Tommasino M, Dalianis T, Näsman A. Time to change perspectives on HPV in oropharyngeal cancer. A systematic review of HPV prevalence per oropharyngeal sub-site the last 3 years. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2017; 4:1-11. [PMID: 29179862 PMCID: PMC5883233 DOI: 10.1016/j.pvr.2017.05.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/12/2017] [Accepted: 05/18/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Human papillomavirus (HPV) as a risk factor in oropharyngeal squamous cell carcinoma (OPSCC) is well established. However, accumulating data imply that the OPSCC concept is too unspecific with regard to HPV prevalence and clinical importance. To further study the role of HPV in OPSCC by sub-site, a systematic review and meta-analysis was performed. MATERIAL AND METHOD PubMed was searched and all studies reporting HPV data (p16/HPV DNA/RNA) in both "lymphoepithelial associated" (i.e. tonsillar and base of tongue cancer; TSCC and BOTSCC respectively) and "non-lymphoepithelial" ("other" OPSCC) OPSCC were included. Pooled odds ratios by HPV detection method were analysed using a random effects model. RESULTS In total, 58 unique patient cohorts were identified. Total HPV prevalence in TSCC/BOTSCC was 56%, 95%CI: 55-57% (59%, 95%CI: 58-60% for TSCC only) as compared to 19%, 95%CI: 17-20%, in "other" OPSCC. Significant association of HPV to TSCC/BOTSCC vs. "other" OPSCC was observed no matter HPV detection method used, but statistical homogeneity was only observed when studies using algorithm based HPV detection were pooled. CONCLUSION HPV prevalence differs markedly between OPSCC sub-sites and while the role of HPV in TSCC/BOTSCC is strong, the role in "other" OPSCC is more uncertain and needs further evaluation.
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Affiliation(s)
- Linnea Haeggblom
- Dept. of Oncology-Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Torbjörn Ramqvist
- Dept. of Oncology-Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden
| | | | - Tina Dalianis
- Dept. of Oncology-Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Anders Näsman
- Dept. of Oncology-Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden; Dept. of Clinical Pathology, Karolinska University Hospital, 171 76 Stockholm, Sweden.
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Lacau St Guily J, Rousseau A, Baujat B, Périé S, Schultz P, Barry B, Dufour X, Malard O, Pretet JL, Clavel C, Birembaut P, Franceschi S. Oropharyngeal cancer prognosis by tumour HPV status in France: The multicentric Papillophar study. Oral Oncol 2017; 67:29-36. [PMID: 28351578 DOI: 10.1016/j.oraloncology.2017.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/03/2017] [Accepted: 01/27/2017] [Indexed: 01/21/2023]
Abstract
AIMS To evaluate the impact of human papillomavirus (HPV) status, tobacco smoking and initial treatment approach on progression-free survival (PFS) and overall survival (OS) for oropharyngeal cancer (OPC) in France, a country where smoking declines started late (1990s). METHODS 340 OPC patients (median age: 60years) from 14 French hospitals were followed up (median 26.7months). PCR-based positivity for both HPV DNA and E6/E7 mRNA was used to distinguish HPV-positive OPC (27.1%). Hospital-stratified hazard ratios (HR) and corresponding 95% confidence intervals (CI) were used to compare PFS and OS according to HPV and other prognostic factors in hospital-stratified unadjusted and multivariate models. The combined effect of HPV status with either smoking, stage, or initial treatment on PFS was also evaluated. RESULTS PFS in multivariate analysis was better in HPV-positive patients (HR=0.42; 95% CI: 0.24-0.73) and worse in older patients (HR for 5-year age increase=1.12) and those having had firstly radiotherapy (HR=1.86; 95% CI: 1.19-2.92) or induction chemotherapy (HR=1.73; 95% CI: 1.08-2.79) instead of upfront surgery. Findings for OS were similar. Loco-regional recurrences were less frequent in HPV-positive (10.5%) than HPV-negative patients (26.0%) but distant recurrences were similarly frequent. HPV status did not modify the influence of smoking or stage on PFS but the impossibility to perform upfront surgery may be more relevant for HPV-negative patients. CONCLUSIONS HPV-positive OPC patients fare better than HPV-negative OPC and may benefit from toxicity-sparing. Whether HPV-negative patients responded less well to radiation and chemotherapy because of more severe genomic damage or bulkier tumours is unclear.
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Affiliation(s)
- Jean Lacau St Guily
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France; Pierre-et-Marie Curie University - Sorbonne Universities, University Cancerology Institute UPMC, Paris, France.
| | - Alexandra Rousseau
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Clinical Pharmacology and Clinical Research Unit of East of Paris (URC-Est), Saint Antoine Hospital, 75012 Paris, France.
| | - Bertrand Baujat
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France; Pierre-et-Marie Curie University - Sorbonne Universities, University Cancerology Institute UPMC, Paris, France.
| | - Sophie Périé
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France; Pierre-et-Marie Curie University - Sorbonne Universities, University Cancerology Institute UPMC, Paris, France.
| | - Philippe Schultz
- Department of Otolaryngology-Head and Neck Surgery, Strasbourg University Hospital - Hautepierre, 67098 Strasbourg Cedex, France.
| | - Béatrix Barry
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Bichat Hospital, and University-Paris 7, 75877 Paris Cedex 18, France.
| | - Xavier Dufour
- Department of Otolaryngology-Head and Neck Surgery, Poitiers University Hospital, 86021 Poitiers Cedex, France.
| | - Olivier Malard
- Department of Otolaryngology-Head and Neck Surgery, Nantes University Hospital - Hotel-Dieu, 44093 Nantes Cedex 1, France.
| | - Jean-Luc Pretet
- Franche-Comte University, COMUE UBFC, Besançon University Hospital - Jean Minjoz, 25030 Besançon Cedex, France; Inserm CIC 1431, 25030 Besançon Cedex, France.
| | - Christine Clavel
- INSERM UMR-S903, Reims University Hospital - Maison Blanche, 51092 Reims Cedex, France.
| | - Philippe Birembaut
- Laboratory of Biopathology, Reims University Hospital - Maison Blanche, Reims-Champagne-Ardenne University, 51092 Reims Cedex, France.
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Ebisumoto K, Okami K, Maki D, Saito K, Shimizu F, Teramura T, Kaneda S, Iida M. Avoidance of postoperative irradiation for cervical lymph node metastases of human papillomavirus-related tonsillar cancer. Laryngoscope Investig Otolaryngol 2017; 2:63-68. [PMID: 28894824 PMCID: PMC5527367 DOI: 10.1002/lio2.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Several reports have suggested that selected patients with human papillomavirus-related oropharyngeal cancer can be managed with surgery alone. We retrospectively reviewed tonsillar cancer cases to analyze treatment de-intensification after transoral resection. METHODS Eighteen patients with tonsillar cancer who had undergone transoral resection were included. The patients' characteristics, p16 status, adverse features, clinical course, overall survival, and relapse-free survival according to p16 status were retrospectively examined. RESULTS Four lesions showed positive surgical margins and one lesion showed close surgical margin; these patients were treated with postoperative irradiation. Seven p16-positive patients had multiple node metastases and two had extracapsular spread. No p16-positive patients agreed to postoperative irradiation, and recurrence within the surgical field was not observed. The five-year overall and relapse-free survival rates were 89% and 74%, respectively. The five-year relapse-free survival rates of p16-positive and p16-negative patients were 81% and 50%, respectively (p = .075). CONCLUSIONS Postoperative irradiation for cervical lymph node metastases might be avoidable in selected patients with human papillomavirus-related tonsillar cancer. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Koji Ebisumoto
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Kenji Okami
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Daisuke Maki
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Kosuke Saito
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Fukuko Shimizu
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Takanobu Teramura
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Shoji Kaneda
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
| | - Masahiro Iida
- Department of Otolaryngology‐Head and Neck SurgeryTokai UniversityKanagawaJapan
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Mizumachi T, Homma A, Sakashita T, Kano S, Hatakeyama H, Fukuda S. Confirmation of the eighth edition of the AJCC/UICC TNM staging system for HPV-mediated oropharyngeal cancer in Japan. Int J Clin Oncol 2017; 22:682-689. [PMID: 28271391 DOI: 10.1007/s10147-017-1107-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 02/25/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Several studies have demonstrated that the seventh edition of the American Joint Committee on Cancer/American Joint Committee on Cancer (AJCC/UICC) TNM staging system does not consistently distinguish between prognostic subgroups for human papillomavirus (HPV)-mediated oropharyngeal squamous cell carcinoma (OPSCC). The eighth edition of the AJCC/UICC TNM staging system came into effect for use with HPV-mediated OPSCC on or after 1 January 2017. This study confirms that the eighth edition of the AJCC/UICC TNM staging system for HPV-mediated OPSCC accurately reflects disease outcomes. PATIENTS AND METHODS We retrospectively analyzed 195 patients with OPSCC treated at Hokkaido University Hospital, Sapporo, Japan between 1998 and 2015. HPV status was evaluated by immunohistochemical analysis of p16. RESULTS Of the 195 OPSCC patients evaluated, 111 (56.9%) were p16 positive and 84 (43.1%) were p16 negative. The 3-year overall survival rate (OS) was significantly lower in the p16-negative patients with stage III-IV in comparison with those with stage I-II (55.0 vs. 93.1%, respectively; p < 0.01). The 3-year OS did not differ significantly between stage I-II and stage III-IV in the p16-positive patients (86.7 vs 87.7%). According to the eighth edition of the AJCC/UICC TNM staging system, stage I-II and stage III can be differentiated on the basis of the 3-year OS in the p16-positive patients (90.9 vs 70.2%, respectively; p < 0.01). CONCLUSIONS The seventh edition of the AJCC/UICC TNM staging system is suitable for use with p16-negative patients; however, it does not effectively discriminate between p16-positive patients. Therefore, the eighth edition of the AJCC/UICC TNM staging system is more suitable for HPV-mediated OPSCC in Japan.
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Affiliation(s)
- Takatsugu Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Tomohiro Sakashita
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Hiromitsu Hatakeyama
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Satoshi Fukuda
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
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Toman J, Von Larson S, Umeno H, Kurita T, Furusaka T, Hasegawa H, Prasad ML, Sasaki CT. HPV-Positive Oropharyngeal Cancer Via p16 Immunohistochemistry in Japan. Ann Otol Rhinol Laryngol 2017; 126:152-158. [PMID: 27913709 DOI: 10.1177/0003489416681582] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) has emerged as a driving cause of head and neck cancer, but investigations outside the West are limited. A p16 immunohistochemistry is a commonly used biomarker for HPV cancers. We sought to investigate the pathology and rates of HPV head and neck oropharyngeal cancer in Japan via p16 immunohistochemistry at 2 institutions in Japan. METHODS Fifty-nine oropharyngeal specimens from 2 university hospitals in Japan were examined for morphology and p16 immunohistochemistry. The rate of p16 positivity was then determined, and the 2 groups were compared for differences in age, smoking history, gender, and stage of presentation and mortality. RESULTS The rate of p16 positivity among the oropharyngeal specimens was 29.5%. There were important differences in the pathology compared to morphology usually seen in the US. The patients with p16+ cancer tended to be younger. There was no significant difference in smoking status. Patients with p16+ cancers trended toward better survival. CONCLUSION There appears to be a geographical difference in HPV rates of oropharyngeal cancers with persistently lower rates in Asian countries when compared to Western Europe and the US. Conclusions about HPV head and neck squamous cell carcinoma (HNSCC) in Western countries may not be generalizable across the globe at this time.
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Affiliation(s)
- Julia Toman
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Hirohito Umeno
- 3 Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Takashi Kurita
- 3 Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Tohru Furusaka
- 4 Department of Otolaryngology and Head & Neck Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Hisashi Hasegawa
- 4 Department of Otolaryngology and Head & Neck Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Manju L Prasad
- 5 Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Clarence T Sasaki
- 1 Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
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Okami K. Clinical features and treatment strategy for HPV-related oropharyngeal cancer. Int J Clin Oncol 2016; 21:827-835. [PMID: 27380170 DOI: 10.1007/s10147-016-1009-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/19/2016] [Indexed: 12/30/2022]
Abstract
Among head and neck squamous cell carcinoma (HNSCC), the incidence of oropharyngeal SCC (OPSCC) is increasing in contrast to carcinoma with origin in other subsites. Human papillomavirus (HPV) is now recognized as a significant risk factor of the carcinogenesis of OPSCC. The HPV-related OPSCC patients tend to be relatively young, less exposed to tobacco and alcohol, and have a relatively high socioeconomic status and education level, which is distinct from HPV-unrelated classical OPSCC. The neck metastases tend to be aggressive and cystic. The better response to treatment resulting in improved prognosis of HPV-related OPSCC led to reconsidering the clinical staging and treatment approaches. Clinical trials of treatment deintensification to reduce the acute and late toxicity without compromising efficacy have been conducted. This review of HPV-related OPSCC focuses on current and generally accepted facts regarding the biology, epidemiology, and therapeutic strategy of this new disease entity.
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Affiliation(s)
- Kenji Okami
- Department of Otolaryngology, Center of Head and Neck Surgery, Tokai University, 143 Shimokasuya, Isehara, 259-1193, Japan.
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38
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Okami K. A new risk factor for head and neck squamous cell carcinoma: human papillomavirus. Int J Clin Oncol 2016; 21:817-818. [PMID: 27368335 DOI: 10.1007/s10147-016-1012-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/21/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Kenji Okami
- Department of Otolaryngology, Center of Head and Neck Surgery, Tokai University, 143 Shimokasuya, Isehara, 259-1193, Japan.
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Nakahara S, Takenaka Y, Ogawa K, Nishiike S, Yamamoto Y, Seo Y, Isohashi F, Suzuki O, Yoshioka Y, Sumida I, Yoshii T, Tomiyama Y, Inohara H. Phase II study of docetaxel, cisplatin, and concurrent radiation followed by platinum-based adjuvant chemotherapy for technically unresectable, locally advanced head and neck squamous cell carcinoma. Int J Clin Oncol 2016; 21:1030-1037. [DOI: 10.1007/s10147-016-0997-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 05/27/2016] [Indexed: 12/17/2022]
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Saito Y, Ando M, Fujimoto C, Omura G, Kobayashi K, Asakage T, Yamasoba T. Human Papillomavirus 16 Physical Status and the TP53 Codon 72 Polymorphism in Japanese HPV-Positive Oropharyngeal Cancer Patients. ORL J Otorhinolaryngol Relat Spec 2016; 78:46-54. [PMID: 26785263 DOI: 10.1159/000442354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/09/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND In human papillomavirus (HPV)-induced carcinogenesis, the arginine (Arg) allele of the TP53 codon 72 polymorphism binds more efficiently to the HPV E6 oncoprotein than the proline (Pro) allele. We investigated the physical status of HPV-16 DNA and the TP53 codon 72 polymorphism in oropharyngeal squamous cell carcinoma (OPSCC). METHODS Tumor samples from 70 p16-positive OPSCC patients were tested for HPV-16 physical status by examining the E2 and E6 open reading frames. The TP53 codon 72 polymorphism was screened by direct sequencing. RESULTS Of 70 patients, 53 were E6 positive, 29 had integrated forms of HPV-16 DNA, and 24 had mixed or episomal forms. Furthermore, 44 carried the Arg/Arg or Arg/Pro genotype, 3 carried the Pro/Pro genotype, and in 6 patients we were unable to obtain sequencing data. CONCLUSIONS HPV-16 physical status was heterogeneous in our OPSCC patients. Most OPSCC patients had the TP53 Arg/Arg or Arg/Pro genotype.
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Affiliation(s)
- Yuki Saito
- Department of Otolaryngology, Head and Neck Surgery, University of Tokyo, Tokyo, Japan
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41
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Chor JSY, Vlantis AC, Chow TL, Fung SC, Ng FYH, Lau CH, Chan ABW, Ho LC, Kwong WH, Fung MNS, Lam EWH, Mak KL, Lam HCY, Kok ASY, Ho WCS, Yeung ACM, Chan PKS. The role of human papillomavirus in head and neck squamous cell carcinoma: A case control study on a southern Chinese population. J Med Virol 2015; 88:877-87. [PMID: 26467027 DOI: 10.1002/jmv.24405] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2015] [Indexed: 12/19/2022]
Abstract
HPV plays a role in the development of a portion of head and neck squamous cell carcinoma (HNSCC), but only limited information on its role in southern Chinese population is available. A multicenter case-control study was conducted. HPV type, viral integration, E6/7 mRNA expression status, and TP53 mutation were determined. A total of 228 HNSCC were recruited including 137 (60.1%) oral SCC, 34 (14.9%) oropharyngeal SCC, 31 (13.6%) laryngeal SCC, 21 (9.2%) hypopharyngeal SCC, and 5 (2.2%) lip and paranasal sinus SCC. High-risk HPV infection was found in 7.5% (17/228) of HNSCC, but only a small proportion of samples had evidence of viral integration (5.3%, 12/228) or E6/7 mRNA expression (4.4%, 10/228). HPV infection with oncogenic phenotype (integration and E6/7 mRNA expression) was significantly more common in oropharyngeal SCC than controls (9/34, 26.5% vs. 0/42, 0.0%, P < 0.001). Smoking showed a significant association with HNSCC, oropharyngeal SCC, and laryngeal SCC. TP53 mutation was associated with HNSCC (P < 0.001). Older age, TP53 mutation, and HPV16 infection with oncogenic phenotypes were independently associated factors for HNSCC with odds ratios of 1.03 (1.02-1.05), 3.38 (1.71-6.66), and 9.19 (1.13-74.68), respectively. High-risk HPV infection of head and neck mucosa is not uncommon in the Hong Kong population. This study found that 26-30% of oropharyngeal carcinoma was associated with HPV infection, mostly HPV16, and that smoking which predisposes to TP53 mutations was another important risk factor.
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Affiliation(s)
- Josette S Y Chor
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Alexander C Vlantis
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tam-Lin Chow
- Department of Surgery, United Christian Hospital, Hong Kong Special Administrative Region, China
| | - Siu-Chung Fung
- Department of Dentistry, United Christian Hospital, Hong Kong Special Administrative Region, China
| | - Fiona Y H Ng
- Department of Surgery, Kwong Wah Hospital, Hong Kong Special Administrative Region, China
| | - Chi-Hung Lau
- Department of Surgery, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China
| | - Amy B W Chan
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Luen-Cheung Ho
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China
| | - Wing-Hang Kwong
- Department of Surgery, North District Hospital, Hong Kong Special Administrative Region, China
| | - Mandy N S Fung
- Department of Pathology, United Christian Hospital, Hong Kong Special Administrative Region, China
| | - Eddy W H Lam
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.,Department of Otorhinolaryngology, Head and Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, China
| | - Kwong-Lin Mak
- Department of Surgery, Princess Margaret Hospital, Hong Kong Special Administrative Region, China
| | - Holly C Y Lam
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Amy S Y Kok
- Department of Surgery, United Christian Hospital, Hong Kong Special Administrative Region, China
| | - Wendy C S Ho
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Apple C M Yeung
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Paul K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Zhang C, Deng Z, Pan X, Uehara T, Suzuki M, Xie M. Effects of Methylation Status of CpG Sites within the HPV16 Long Control Region on HPV16-Positive Head and Neck Cancer Cells. PLoS One 2015; 10:e0141245. [PMID: 26509736 PMCID: PMC4625038 DOI: 10.1371/journal.pone.0141245] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 10/05/2015] [Indexed: 12/31/2022] Open
Abstract
Objective To map comprehensively the methylation status of the CpG sites within the HPV16 long control region (LCR) in HPV-positive cancer cells, and to explore further the effects of methylation status of HPV16 LCR on cell bioactivity and E6 and E7 expression. In addition, to analyze the methylation status of the LCR in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) patients. Methods and Materials Methylation patterns of HPV16 LCR in UM-SCC47, CaSki, and SiHa cells and HPV16-positiive OPSCC specimens were detected by bisulfite-sequencing PCR and TA cloning. For cells treated with 5-aza-2′-deoxycytidine and E6 and E7 knockdown, MTS and trypan blue staining, annexin-V and 7-AAD staining, and prodidium iodide were used to evaluate cell growth and cell proliferation, cell apoptosis, and cell cycle arrest, respectively. E6 and E7 mRNA and protein expression were analyzed by quantitative real-time PCR and immunocytochemistry, respectively. Results Hypermethylation status of the LCR in UM-SCC47 (79.8%) and CaSki cells (90.0%) and unmethylation status of the LCR in SiHa cells (0%) were observed. Upon demethylation, the cells with different methylation levels responded differently during growth, apoptosis, and cell cycle arrest, as well as in terms of their E6 and E7 expression. In HPV16-positive OPSCC patients, the methylation rates were 9.5% in the entire LCR region, 13.9% in the 5′-LCR, 6.0% in the E6 enhancer, and 9.5% in the p97 promoter, and hypermethylation of p97 promoter was found in a subset of cases (20.0%, 2/10). Conclusions Our study revealed two different methylation levels of the LCR in HPV16-positive cancer cells and OPSCC patients, which may represent different carcinogenesis mechanisms of HPV-positive cancers cells. Demethylating the meCpGs in HPV16 LCR might be a potential target for a subgroup of HPV16-positive patients with head and neck squamous cell carcinoma.
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Affiliation(s)
- Chunlin Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Otorhinolaryngology, Head and Neck Surgery, University of the Ryukyus, Okinawa, Japan
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated hospital of Zunyi Medical University, Zunyi, China
| | - Zeyi Deng
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Otorhinolaryngology, Head and Neck Surgery, University of the Ryukyus, Okinawa, Japan
| | - Xiaoli Pan
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Otorhinolaryngology, Head and Neck Surgery, University of the Ryukyus, Okinawa, Japan
- Department of Otorhinolaryngology, Head and Neck Surgery, The First People’s Hospital of Guangzhou, Guangzhou, China
| | - Takayuki Uehara
- Department of Otorhinolaryngology, Head and Neck Surgery, University of the Ryukyus, Okinawa, Japan
| | - Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, University of the Ryukyus, Okinawa, Japan
- * E-mail: (MX); (MS)
| | - Minqiang Xie
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- * E-mail: (MX); (MS)
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Kimura K, Kodaira T, Tomita N, Tachibana H, Makita C, Yoshida M, Nishikawa D, Hirakawa H, Suzuki H, Hanai N, Hasegawa Y. Clinical results of definitive intensity-modulated radiation therapy for oropharyngeal cancer: retrospective analysis of treatment efficacy and safety. Jpn J Clin Oncol 2015; 46:78-85. [PMID: 26496935 DOI: 10.1093/jjco/hyv157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 09/25/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To evaluate the clinical outcomes of intensity-modulated radiotherapy for patients with oropharyngeal carcinoma. METHODS Ninety-three oropharyngeal carcinoma patients histopathologically diagnosed with squamous cell carcinoma and treated with definitive intensity-modulated radiotherapy using helical tomotherapy between January 2006 and December 2013 were analyzed. Planning target volume primary and involved nodes was delivered 66-70 Gy at 2 Gy per fraction, while planning target volume prophylactic was delivered 54 Gy using the simultaneous integrated boost technique. RESULTS The median follow-up period among the surviving patients was 40 months (range, 13-96). There were 76 males and 17 females with a median age of 60 years (range, 34-80). The disease was Stage II in 13%, Stage III in 10% and Stage IV in 77% of patients. Ninety-two patients received chemotherapy (99%); 68 patients received induction chemotherapy (73%), while 21 received concurrent chemotherapy (23%). The 3-year overall survival, progression-free survival and locoregional control rates were 80, 68 and 79%, respectively. Multivariate analysis identified an advanced T-category (T3-4), having double cancer, and smoking habit as significantly unfavorable factors for overall survival, progression-free survival and both progression-free survival and locoregional control, respectively. Only two patients who achieved disease control required percutaneous endoscopic gastrostomy tubes in the last follow-up. The rate of Grade 2 xerostomia at 2 years was 23%. CONCLUSIONS Intensity-modulated radiotherapy using helical tomotherapy for patients with oropharyngeal carcinoma provided not only sufficient efficacy, but also preserved parotid function.
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Affiliation(s)
- Kana Kimura
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya
| | - Natsuo Tomita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya
| | - Hiroyuki Tachibana
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya
| | - Chiyoko Makita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya
| | - Maiko Yoshida
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya
| | - Daisuke Nishikawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
| | - Hitoshi Hirakawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
| | - Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
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Oguejiofor K, Hall J, Slater C, Betts G, Hall G, Slevin N, Dovedi S, Stern PL, West CML. Stromal infiltration of CD8 T cells is associated with improved clinical outcome in HPV-positive oropharyngeal squamous carcinoma. Br J Cancer 2015; 113:886-93. [PMID: 26313665 PMCID: PMC4578081 DOI: 10.1038/bjc.2015.277] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/02/2015] [Accepted: 06/29/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) have a better prognosis than those with HPV-negative tumours. There is interest in de-escalating their treatment but strategies are needed for risk stratification to identify subsets with a poor prognosis. This study investigated tumour-infiltrating lymphocytes (TILs) in relation to HPV tumour status and patient survival. METHODS Biopsies from 218 patients diagnosed with OPSCC between 2002 and 2011, who underwent chemo/radiotherapy were analysed for HPV by PCR, in-situ hybridisation and p16 immunohistochemistry (IHC). One hundred and thirty-nine samples with concordant HPV detection were analysed for CD3, CD4, CD8 and FoxP3 expression in tumour and stromal regions using multiplexIHC and multispectral image analysis. Labelling of smooth muscle actin (SMA) identified activated stroma. RESULTS Human papillomavirus-positive compared with HPV-negative OPSCC had higher infiltration in both tumour and stromal areas of CD4 and CD8 T cells but not FoxP3 T regulatory cells. Only CD3+CD8+ stromal and not tumour area infiltration was associated with increased survival (P=0.02). There was significantly higher SMA expression in HPV-positive compared with -negative tumours, which did not correlate with survival. CONCLUSIONS Studies of TILs for risk stratification in OPSCC should assess stromal infiltration.
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Affiliation(s)
- K Oguejiofor
- Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Wilmslow Road, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, Wilmslow Road, UK
| | - J Hall
- Lymphoma Translational Research Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Wilmslow Road, Manchester, UK
| | - C Slater
- Lymphoma Translational Research Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, Manchester Medical School, University of Manchester, Wilmslow Road, Manchester, UK
| | - G Betts
- Central Manchester University Hospitals, Manchester, UK
| | - G Hall
- Central Manchester University Hospitals, Manchester, UK
| | - N Slevin
- The Christie NHS Foundation Trust, Manchester, Wilmslow Road, UK
| | - S Dovedi
- Targeted Therapy Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, the University of Manchester; Wilmslow Road, Manchester
| | - P L Stern
- Center for Women's Cancer, Institute of Cancer Sciences, University of Manchester, Paterson Building, Wilmslow Road, Manchester, M20 4BX, UK
| | - C M L West
- Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Wilmslow Road, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, Wilmslow Road, UK
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Mizumachi T, Kano S, Sakashita T, Hatakeyama H, Homma A, Fukuda S. [A clinical study of cases diagnosed as being oropharyngeal carcinoma after cervical mass extirpation/biopsy]. ACTA ACUST UNITED AC 2015; 117:1463-70. [PMID: 25946828 DOI: 10.3950/jibiinkoka.117.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In the case of oropharyngeal carcinoma, patients may present with symptoms similar to cervical lymphadenopathy, and the primary lesion may only be diagnosed after cervical mass extirpation/biopsy. We retrospectively analyzed the clinical course in 11 oropharyngeal carcinoma patients that were diagnosed after cervical mass extirpation/biopsy between 1998 and 2013. Before the diagnosis was made of oropharyngeal carcinoma, a cervical lymph node biopsy was performed in six patients; the lymph node was extirpated due to an initial diagnosis of lateral cervical cyst in four patients; and neck dissection was performed due to an initial diagnosis of primary unknown carcinoma in one patient. The primary tumor site in the oropharynx was the palatine tonsil in six patients and the lingual tonsil in five patients. Five of six patients with palatine tonsil carcinoma and three of five patients with lingual tonsil carcinoma were found to be positive for human papillomavirus (HPV). The duration from cervical lymph node extirpation/biopsy to final diagnosis was 1 to 13 months. All patients finally underwent radiation therapy or chemoradiotherapy, and they had no recurrence or metastasis. As the incidence of HPV-related oropharyngeal carcinoma increases, the number of oropharyngeal carcinomas assumed to be cervical lymphadenopathy due to the presenting symptoms may increase. It is important to investigate the oropharynx thoroughly so as to adequately differentiate the possibility of oropharyngeal carcinoma from that of cervical lymphadenopathy. Metastatic lymph nodes might present as cysts in cases of oropharyngeal carcinoma, it is therefore necessary to take the potential for metastatic lymph nodes in the oropharyngeal cancer into consideration when differentiating this disease from cervical cyst-shaped lesions.
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