Characteristics and survival of head and neck cancer by HPV status: a cancer registry‐based study

Sethi, Seema; Ali-Fehmi, Rouba; Franceschi, Silvia; Struijk, Linda; Doorn, Leen Jan Van; Quint, Wim; Albashiti, Bassam; Ibrahim, Maria Salem; Kato, Ikuko

doi:10.1002/ijc.26500

Cited by 94 publications

(103 citation statements)

References 34 publications

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“…Rates of HPV positivity in the literature vary depending on the detection method used and the tissue types tested. Our rate of HR HPV positivity does not appear to differ significantly from a 2012 cancer registry study by Sethi et al [20] which had a prevalence of 29.4 % HPV positivity for carcinomas at all head and neck sites and reported a 50.6 % prevalence within carcinomas of the oropharynx. In the same study by Sethi et al [20] it was confirmed that HPV positivity (in large part HPV16), was associated with improved survival and that the survival advantage of HPV-positivity was limited to oropharyngeal sites.…”

Section: Resultscontrasting

confidence: 65%

“…Our rate of HR HPV positivity does not appear to differ significantly from a 2012 cancer registry study by Sethi et al [20] which had a prevalence of 29.4 % HPV positivity for carcinomas at all head and neck sites and reported a 50.6 % prevalence within carcinomas of the oropharynx. In the same study by Sethi et al [20] it was confirmed that HPV positivity (in large part HPV16), was associated with improved survival and that the survival advantage of HPV-positivity was limited to oropharyngeal sites. Thus, in the absence of evidence for a prognostic role of HPV testing outside of the oropharynx and metastatic neck lymph nodes, these locations may not need HPV-ISH testing unless histologic and/or clinical features otherwise suggest HPV related cancers [21,22].…”

Section: Resultscontrasting

confidence: 65%

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Use of In Situ Hybridization for HPV in Head and Neck Tumors: Experience from a National Reference Laboratory

Witt

Albertson

Coppin

et al. 2014

Head and Neck Pathol

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The human papillomavirus (HPV) status of head and neck squamous cell carcinomas (SCCs) is a frequent request for Anatomic Pathology labs. However, prognostic value of HPV status is limited to identification of high risk HPV in oropharyngeal SCCs. The purpose of this study is to investigate the ordering practices of in situ hybridization (ISH) for HPV in head and neck tissues at our national reference laboratory. All testing orders for low risk, high risk, and combined low and high risk HPV-ISH tests requested at ARUP Laboratories between January 2010 and November 2013 had their results reviewed and were grouped by anatomic location of the tested tissue. The H&E and HPV-ISH slides from a sample of the most recent 123 tests were reviewed by two pathologists. A total of 1,128 HPV-ISH tests were ordered during the study period. Testing for combined low and high risk HPV was the most commonly ordered test. The positivity rate for high risk HPV was highest in oropharyngeal tissues. 49 of 123 reviewed cases had testing requested on non-malignant tissue, 11 of which were non-neoplastic. Unnecessary HPV-ISH ordering is prevalent in head and neck tissues. Dual testing for low and high risk HPV, frequent testing outside of the oropharynx, and testing non-neoplastic tissues appear to be common practices.

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Section: Resultscontrasting

confidence: 65%

Section: Resultscontrasting

confidence: 65%

Use of In Situ Hybridization for HPV in Head and Neck Tumors: Experience from a National Reference Laboratory

Witt

Albertson

Coppin

et al. 2014

Head and Neck Pathol

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“…In another study of 57 oropharyngeal cancers, improved prognosis was observed among p16 positive versus negative cases initially treated with either radiotherapy or chemoradiotherapy (log-rank test p = 0.10) or by surgery with or without adjuvant radiotherapy (p = 0.07) [44]. A recent study similarly found improved overall survival in HPV-positive as compared to HPV-negative oropharyngeal cancers treated with radiotherapy, but found no improvement among those receiving no radiotherapy [45]. While estimates did not reach statistical significance, likely due to small numbers, our results showed an improvement in overall survival comparing HPV16 positive with HPV16 negative oropharyngeal cancers, irrespective of initial therapy.…”

Section: Discussionmentioning

confidence: 96%

Human Papillomavirus-Associated Head and Neck Squamous Cell Carcinoma Survival: A Comparison by Tumor Site and Initial Treatment

Salazar

Smith

Garg

et al. 2013

Head and Neck Pathol

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Recent evidence suggests that human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC) patients have better survival than HPV-negative patients. However, it is unclear if similar patterns for survival exist across different tumor sites, and whether HPV-associated prognosis is modified by type of treatment. We prospectively tested 222 histologically confirmed HNSCC primary tumors for HPV DNA by PCR and HPV E6/E7 RNA by RT-PCR prior to treatment at a large urban health center. Cox proportional hazard ratio models were constructed to assess HPV-associated differences in overall and disease-specific survival adjusting for clinical and demographic covariates. HPV detection varied significantly by primary HNSCC tumor site, from 35 % for oropharynx, to 25 % for hypopharynx, 5 % for larynx, and 3 % for oral cavity (p \ 0.0001), with HPV16 accounting for the majority (95 %) of HPV-positive tumors. The hazard-risk of overall and disease-specific death comparing HPV16-positive versus negative oropharyngeal HNSCC was reduced by 74 and 89 %, respectively (p values \ 0.05), and was independent of other prognostic indicators; no statistically significant changes in outcomes were observed for non-oropharyngeal HNSCC sites. Prediction of overall survival was better with combined DNA and RNA HPV16 positive PCR detection. There was no difference in HPV16-associated survival whether patients received either surgery or (chemo)radiotherapy as their initial treatment modality. Improved HPV-associated HNSCC survival is limited to Electronic supplementary material The online version of this article

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“…Several studies have noted that younger patients with H&N cancer squamous cell carcinoma (HNSCC) and minimal to no smoking history are more likely to have HPV-positive tumors compared to older patients. [23][24][25] Furthermore, patients with HPV-positive HNSCC generally tend to have better prognosis compared to their HPV-negative counterparts. [26][27][28] In this study, patients in the oral cavity and hypopharynx groups had low primary tumor volume reduction, which fits into the general response pattern for these subsites.…”

Section: Discussionmentioning

confidence: 99%

Decision Trees Predicting Tumor Shrinkage for Head and Neck Cancer

Sürücü

Shah

Mescioglu

et al. 2015

Technol Cancer Res Treat

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Objective: To develop decision trees predicting for tumor volume reduction in patients with head and neck (H&N) cancer using pretreatment clinical and pathological parameters. Methods: Forty-eight patients treated with definitive concurrent chemoradiotherapy for squamous cell carcinoma of the nasopharynx, oropharynx, oral cavity, or hypopharynx were retrospectively analyzed. These patients were rescanned at a median dose of 37.8 Gy and replanned to account for anatomical changes. The percentages of gross tumor volume (GTV) change from initial to rescan computed tomography (CT; %GTVD) were calculated. Two decision trees were generated to correlate %GTVD in primary and nodal volumes with 14 characteristics including age, gender, Karnofsky performance status (KPS), site, human papilloma virus (HPV) status, tumor grade, primary tumor growth pattern (endophytic/exophytic), tumor/nodal/group stages, chemotherapy regimen, and primary, nodal, and total GTV volumes in the initial CT scan. The C4.5 Decision Tree induction algorithm was implemented. Results: The median %GTVD for primary, nodal, and total GTVs was 26.8%, 43.0%, and 31.2%, respectively. Type of chemotherapy, age, primary tumor growth pattern, site, KPS, and HPV status were the most predictive parameters for primary %GTVD decision tree, whereas for nodal %GTVD, KPS, site, age, primary tumor growth pattern, initial primary GTV, and total GTV volumes were predictive. Both decision trees had an accuracy of 88%. Conclusions: There can be significant changes in primary and nodal tumor volumes during the course of H&N chemoradiotherapy. Considering the proposed decision trees, radiation oncologists can select patients predicted to have high %GTVD, who would theoretically gain the most benefit from adaptive radiotherapy, in order to better use limited clinical resources.

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Characteristics and survival of head and neck cancer by HPV status: a cancer registry‐based study

Cited by 94 publications

References 34 publications

Use of In Situ Hybridization for HPV in Head and Neck Tumors: Experience from a National Reference Laboratory

Use of In Situ Hybridization for HPV in Head and Neck Tumors: Experience from a National Reference Laboratory

Human Papillomavirus-Associated Head and Neck Squamous Cell Carcinoma Survival: A Comparison by Tumor Site and Initial Treatment

Decision Trees Predicting Tumor Shrinkage for Head and Neck Cancer

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