Human papillomavirus is a favourable prognostic factor in cancer of unknown primary in the head and neck region and in hypopharyngeal cancer

Abstract

Abstract. Human papillomavirus (HPV), in addition to smoking and alcohol, is a cause of oropharyngeal squamous cell carcinoma (OPSCC), particularly of the tonsils and base of the tongue (TSCC and BOTSCC, respectively). Moreover, HPV-positive TSCC and BOTSCC are associated with a better outcome compared with their HPV-negative counterparts (80 vs. 40% 3-year disease-free survival rate, respectively) and their incidence has increased in several countries. Recently, accumulating evidence of HPV in a considerable proportion of cancers of unknown primary (CUP) in the head and neck region and in a small proportion of hypopharyngeal SCCs has been reported. Furthermore, HPV-positive tumours, particularly cases with HPV DNA positivity in combination with overexpression of p16, also tend to have a better clinical outcome compared with that of the corresponding HPV-negative tumours. This finding is particularly prominent in HPV-positive CUPs of the head and neck region, where the primary tumour likely originates from the oropharynx. Thus, the determination of HPV status and p16 expression may be of value for the diagnosis and treatment of CUP of the head and neck region and may also be of value for hypopharyngeal cancers in the future. However, for hypopharyngeal cancer as well as other non-OPSCCs, additional studies per subsite on the effect of HPV status on survival are required.

Antibodies against human papillomaviruses as diagnostic and prognostic biomarker in patients with neck squamous cell carcinoma from unknown primary tumor

“…To our knowledge, this is the first study assessing HPV antibodies in NSCCUP patients, whereas HPV16 antibodies have been comprehensively studied in OPSCC patients, revealing similar antibody patterns. The fact that antibody patterns strongly associated with HPV‐driven OPSCC, are present in patients with HPV‐driven NSCCUP, is supporting previous suggestions that HPV‐driven NSCCUP are most likely derived from the oropharynx . We could validate the recently suggested algorithm to define HPV16‐seropositive patients by ( i ) high HPV16 E6 antibody levels, or ( ii ) antibodies against at least three early proteins .…”

“…Among the most promising biomarkers in NSCCUP is the human papillomavirus (HPV). 1 HPV, in particular HPV type 16, is causally associated with a subset of oropharyngeal squamous cell carcinomas (OPSCC). 2 HPV-driven tumors are frequent among OPSCC, but are rare among other head and neck cancers.…”

Cáncer de cabeza y cuello en Uruguay. Análisis de sobrevida en dos centros de referencia

“…En la actualidad la sobrevida de los pacientes con cáncer de orofaringe está condicionada por la asociación con el virus del papiloma humano (VPH). El estado de VPH positivo confiere un mejor pronóstico para el cáncer de orofaringe, hipofaringe y adenopatías metastásicas con primitivo desconocido (17,18) . El mejor pronóstico se asocia a pacientes de menor edad, no tabaquistas -no alcoholistas, y a una mejor respuesta a la radioquimioterapia (19)(20)(21) .…”

Unilateral radiotherapy treatment for p16/human papillomavirus–positive squamous cell carcinoma of unknown primary in the head and neck

“…Particularly controversial has been the issue of unilateral versus bilateral neck treatment and the volume of mucosa harboring potential putative primary sites that should be encompassed prophylactically with radiotherapy. It is now known that a number of unknown primary cancers are associated with the human papillomavirus (HPV), which have a high probability of arising from the oropharynx . HPV oropharyngeal cancers are often difficult to see and/or palpate, as they are small and often lie deep in the crypts of the tonsil or base of tongue.…”