Prognostic Score Predicts Survival in HPV-Negative Head and Neck Squamous Cell Cancer Patients

Abstract

Although patients having head and neck squamous cell carcinoma (HNSCC) have high mortality, standardized prognostic tools are unavailable. As such, having a validated simple prognostic scoring system to help predict mortality in these high-risk patients is urgently needed. The current study aimed to develop and internally validate a prognostic scoring system for overall mortality in human papillomavirus (HPV)-independent HNSCC patients. Data on 400 consecutive patients from the Cancer Genome Atlas database with a known HPV-RNA negative status were analyzed. A prognostic model to predict patient overall mortality was developed using the logistic regression beta coefficients and a simple risk score was created. The model was internally validated using bootstrap validation with 2000 replications. Five covariates (age, pT, pN, perineural invasion, and EAp53 score) were used in the development of the mortality risk score in the final model. Three risk groups were stratified based on the prognostic scores: low-risk (<96 points), medium-risk (96-121 points), and high-risk (≥122 points) with a survival of 76%, 62% and 35%, respectively. The proposed model presented good discrimination in both the development (AUC = 0.76; 95% CI 0.70, 0.81) and bootstrap validation (AUC = 0.76; 95% CI 0.70, 0.81) with a non-significant Hosmer-Lemeshow chi-square of 6.17 (p = 0.63). The proposed prognostic scoring system is easy to use to predict patient overall mortality and could also help in the appropriate allocation of medical resources while managing HNSCC patients. External validation (including re-calibration if needed) should be conducted to test the model's generalizability in different populations.

PSMC2, ORC5 and KRTDAP are specific biomarkers for HPV‑negative head and neck squamous cell carcinoma

“…The molecular mechanisms underlying these two subtypes are different ( 19 ). Furthermore, HPV-negative HNSCC is more aggressive than HPV-positive HNSCC ( 20 , 21 ). Therefore, the identification of novel and specific biomarkers for HPV-negative HNSCC may improve the understanding of the specific molecular mechanism associated with HPV-negative HNSCC, which may improve the diagnosis and treatment of patients.…”

The correlation and clinical significance of PIK3CA, PIK3CB and HPV infection in esophageal squamous cell carcinoma

“…Clinicopathological factors, molecular biomarkers, and HPV infection may be predictive variables of ESCC [20,21]. In head and neck cancer, patients with HPV-positive cancer have better therapeutic outcome and higher survival rate than patients with HPV-negative cancer [22][23][24]. A similar correlation possibly exists, because the esophagus may also be infected with HPV [25].…”

Insights into Nanomedicine for Immunotherapeutics in Squamous Cell Carcinoma of the head and neck

“…Currently, carcinogen-exposure-associated tumors represent the majority of HNSCCs with a rising incidence of high-risk human papillomavirus (HR-HPV)-driven HNSCCs [30]. HR-HPV-driven HNSCCs show distinct clinical presentations regarding treatment response, overall survival and prognosis compared to HR-HPV negative HNSCCs [31]. Accordingly, the 8th edition of the American Joint Committee on Cancer (AJCC) downstaged the HR-HPV-associated OPC compared to HR-HPV negative OPC [32].…”