HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes

Cheraghlou, Shayan; Torabi, Sina J.; Husain, Zain; Otremba, Michael; Osborn, Heather A.; Mehra, Saral; Yarbrough, Wendell G.; Burtness, Barbara; Judson, Benjamin L.

doi:10.1002/lary.27475

Cited by 45 publications

(49 citation statements)

References 57 publications

(143 reference statements)

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“…Current research suggests that HPV infection is etiologic agent in > 70% of newly diagnosed cases 12 and is associated with improved survival. 14,15 Not surprisingly, p16 positivity has also been shown to improve survival in the setting of CUP. P16-negative CUP is associated with worse survival and fortunately is a rare clinical entity.…”

Section: Discussionmentioning

confidence: 99%

“…P16-negative CUP is associated with worse survival and fortunately is a rare clinical entity. 15,16 At our institutions, the success of BOT mucosectomy in p16-positive disease has led to an application of this practice to p16-negative CUP. Naturally, prior to proceeding with TORS in this patient population, a comprehensive endoscopic evaluation is pursued to rule out a hypopharyneal, laryngeal, or nasopharyngeal primary.…”

Section: Discussionmentioning

confidence: 99%

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TORS Base‐of‐Tongue Mucosectomy in Human Papilloma Virus‐Negative Carcinoma of Unknown Primary

et al. 2020

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Objective To analyze the role of transoral robotic base‐of‐tongue mucosectomy in a cohort of patients with human papilloma virus negative unknown primary carcinoma. Study Design Retrospective database analysis. Methods A retrospective database review from 2012 to 2018 was performed at two large tertiary centers to study patients with human papilloma virus (HPV)‐negative unknown primary carcinoma who underwent transoral robotic base‐of‐tongue mucosectomy. P16 testing was used as a surrogate for HPV status. Patients were included that had squamous cell carcinoma metastatic to the lateral neck based on fine needle aspiration or open biopsy. Preoperatively, all patients were classified as having an unknown primary based on normal clinical and flexible endoscopic exam, normal operative endoscopy, nonlocalizing imaging, and tonsillectomy. All patients underwent robotic base‐of‐tongue mucosectomy. The primary outcome measure was the incidence of pathologic identification of a mucosal primary. Results Twenty‐three patients with p16‐negative unknown primary carcinoma were identified and studied. All patients underwent transoral robotic base‐of‐tongue mucosectomy. Median age was 60 years at the time of diagnosis, and 18 of 23 (78.2%) were male. Pathologic analysis of the base‐of‐tongue specimens showed a primary tumor in only three of 23 (13.0%) of patients. Conclusion Despite prior evidence suggesting a high rate of primary site identification in HPV‐related disease, robotic base‐of‐tongue mucosectomy may not be indicated for HPV‐negative unknown primary carcinoma based on a low likelihood of finding the primary. Level of Evidence 4 Laryngoscope, 131:78–81, 2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

TORS Base‐of‐Tongue Mucosectomy in Human Papilloma Virus‐Negative Carcinoma of Unknown Primary

et al. 2020

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“…A collaboration between the American College of Surgeons (ACS) and the Commission on Cancer (CoC), the NCDB collects data from over 1,500 hospital in the United States, representing over 70% of all new diagnoses of cancer as previously described . The NCDB has been used in a number of studies to study outcomes in head and neck . This study was determined to be exempt from institutional review by the Yale Human Investigation Committee.…”

Section: Methodsmentioning

confidence: 99%

Margins in Sinonasal Squamous Cell Carcinoma: Predictors, Outcomes, and the Endoscopic Approach

Torabi

Spock²,

Cardoso

et al. 2019

The Laryngoscope

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Objectives: To identify factors associated with positive margins following surgical management of sinonasal squamous cell carcinoma (SNSCC), especially with regard to endoscopic treatment.Methods: In a retrospective analysis of adult patients with clinically staged tumor (T)1 to T4a SNSCC within the National Cancer Database (NCDB) from 2004 to 2014, factors were associated with positive margins using multivariable binary logistic regression. Cases from 2010 to 2014 had surgical approach (open vs. endoscopic) available and were analyzed in a subgroup to assess the association of surgical approach with margin status. The association of margin status with overall survival (OS) and additional therapy administration was also assessed.Results: We identified 2,968 cases, of which 807 (27.2%) had positive margins. On multivariable analysis, factors associated with positive margins included higher T stage (T4a vs. T1: odds ratio [OR] 2.768 [95% CI 2.143-3.577]), less differentiated tumors (poorly differentiated vs. well differentiated: OR 1.403 [95% CI 1.060-1.856]), and tumors in the ethmoid sinus (vs. nasal cavity; OR 1.889 [95% CI 1.305-2.734]). Cases treated at higher volume facilities (HVFs) were associated with a lower likelihood of positive margins (OR 0.716 [95% CI 0.582-0.881]). Positive margins were associated with decreased OS (hazard ratio 1.672 [95% CI 1.464-1.908]) and an increased rate of additional therapy (OR 1.966 [95% confidence interval 1.597-2.421]). An endoscopic approach was not associated with an increased likelihood of obtaining positive margins (vs. open; OR 1.151 [0.903-1.651]).Conclusion: Positive margins were less likely when performed at HVFs and more likely in the ethmoid sinus than other subsites. Importantly, there was no association between positive margins and surgical approach. Endoscopic surgery may offer a safe, less invasive alternative to open surgery for select patients.

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“…There are two primary causes of HNC: Tobacco and alcohol use, and human papillomavirus infection (32). Previous studies have shown that HPV infection plays a role in the pathogenesis of head and neck tumors (33–35). The oncomine analysis of cancer vs. normal tissue for IL8, IL1B and SERPINA1 demonstrated that the expression was compared with the normal tissues (Fig.…”

Section: Discussionmentioning

confidence: 99%

Screening and identification of potential target genes in head and neck cancer using bioinformatics analysis

Chen

Zheng

et al. 2019

Oncol Lett

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Head and neck cancer (HNC) is the sixth most common cancer worldwide. Recent studies on the pathogenesis of HNC have identified some biochemical associations of this disease, but the molecular mechanisms are not clear. To explore the genetic alterations in head and neck tumors, to identify new high-specificity and high-sensitivity tumor markers, and to investigate potentially effective therapeutic targets, in silico methods were used to study HNC. The GSE58911 microarray dataset was downloaded from the Gene Expression Omnibus online database to identify potential target genes in the carcinogenesis and progression of HNC. Differentially expressed genes (DEGs) were identified and functional enrichment analysis was performed. In addition, a protein-protein interaction network was also constructed, and gene analysis was undertaken using Search Tool for the Retrieval of Interacting Genes and Cytoscape. A total of 648 differentially expressed genes were identified. Kyoto Encyclopedia of Genes and Genomes pathway and Gene Ontology functional enrichment analysis of DEGs included muscle system process, extracellular matrix organization, actin binding, structural molecule activity, structural constituent of muscle, extracellular region part, ECM-receptor interaction, amoebiasis, focal adhesion, drug metabolism-cytochrome P450, and chemical carcinogenesis. There were 26 hub genes identified and biological process analysis revealed that these genes were mainly enriched in extracellular matrix organization, serine-type endopeptidase activity, extracellular matrix, and complement and coagulation cascades. Survival analysis revealed that interleukin (IL)-8 (C-X-C motif chemokine ligand 8), IL1B, and serpin family A member 1 may be involved in the carcinogenesis of HNC. In summary, the DEGs and hub genes identified in the present study may increase understanding of the molecular mechanisms of development of HNC and provide potential target genes for clinical diagnosis and targeted therapy.

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HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes

Abstract: 4.

Cited by 45 publications

References 57 publications

TORS Base‐of‐Tongue Mucosectomy in Human Papilloma Virus‐Negative Carcinoma of Unknown Primary

TORS Base‐of‐Tongue Mucosectomy in Human Papilloma Virus‐Negative Carcinoma of Unknown Primary

Margins in Sinonasal Squamous Cell Carcinoma: Predictors, Outcomes, and the Endoscopic Approach

Screening and identification of potential target genes in head and neck cancer using bioinformatics analysis

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