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p16-positive lymph node metastases from cutaneous head and neck squamous cell carcinoma: No association with high-risk human papillomavirus or prognosis and implications for the workup of the unknown primary.
Cancer. 2016 Apr 15; 122(8):1201-8.C

Abstract

BACKGROUND

The incidence of p16 overexpression and the role of human papillomavirus (HPV) in cutaneous head and neck squamous cell carcinoma (cHNSCC) are unclear.

METHODS

One hundred forty-three patients with cHNSCC lymph node metastases involving the parotid gland were evaluated for p16 expression by immunohistochemistry. The detection of 18 high-risk HPV subtypes was performed with HPV RNA in situ hybridization for a subset of 59 patients. The results were correlated with clinicopathological features and outcomes.

RESULTS

The median follow-up time was 5.3 years. No differences were observed in clinicopathological factors with respect to the p16 status. p16 was positive, weak, and negative in 45 (31%), 21 (15%), and 77 cases (54%), respectively. No high-risk HPV subtypes were identified, regardless of the p16 status. The p16 status was not prognostic for overall (hazard ratio, 1.08; 95% confidence interval [CI], 0.85-1.36; P = .528), cancer-specific (hazard ratio, 1.12; 95% CI, 0.77-1.64; P = .542), or progression-free survival (hazard ratio, 1.03; 95% CI, 0.83-1.29; P = .783). Distant metastasis-free survival, freedom from locoregional failure, and freedom from local failure were also not significantly associated with the p16 status.

CONCLUSIONS

p16 positivity is common but not prognostic in cHNSCC lymph node metastases. High-risk HPV subtypes are not associated with p16 positivity and do not appear to play a role in this disease. HPV testing, in addition to the p16 status in the unknown primary setting, may provide additional information for determining a putative primary site.

Authors+Show Affiliations

Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia.Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia.Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia. University of Melbourne, Parkville, Australia.University of Melbourne, Parkville, Australia. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia. University of Melbourne, Parkville, Australia. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia. University of Melbourne, Parkville, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26881928

Citation

McDowell, Lachlan J., et al. "P16-positive Lymph Node Metastases From Cutaneous Head and Neck Squamous Cell Carcinoma: No Association With High-risk Human Papillomavirus or Prognosis and Implications for the Workup of the Unknown Primary." Cancer, vol. 122, no. 8, 2016, pp. 1201-8.
McDowell LJ, Young RJ, Johnston ML, et al. P16-positive lymph node metastases from cutaneous head and neck squamous cell carcinoma: No association with high-risk human papillomavirus or prognosis and implications for the workup of the unknown primary. Cancer. 2016;122(8):1201-8.
McDowell, L. J., Young, R. J., Johnston, M. L., Tan, T. J., Kleid, S., Liu, C. S., Bressel, M., Estall, V., Rischin, D., Solomon, B., & Corry, J. (2016). P16-positive lymph node metastases from cutaneous head and neck squamous cell carcinoma: No association with high-risk human papillomavirus or prognosis and implications for the workup of the unknown primary. Cancer, 122(8), 1201-8. https://doi.org/10.1002/cncr.29901
McDowell LJ, et al. P16-positive Lymph Node Metastases From Cutaneous Head and Neck Squamous Cell Carcinoma: No Association With High-risk Human Papillomavirus or Prognosis and Implications for the Workup of the Unknown Primary. Cancer. 2016 Apr 15;122(8):1201-8. PubMed PMID: 26881928.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - p16-positive lymph node metastases from cutaneous head and neck squamous cell carcinoma: No association with high-risk human papillomavirus or prognosis and implications for the workup of the unknown primary. AU - McDowell,Lachlan J, AU - Young,Richard J, AU - Johnston,Meredith L, AU - Tan,Tze-Jian, AU - Kleid,Stephen, AU - Liu,Chen S, AU - Bressel,Mathias, AU - Estall,Vanessa, AU - Rischin,Danny, AU - Solomon,Benjamin, AU - Corry,June, Y1 - 2016/02/16/ PY - 2015/11/11/received PY - 2015/12/18/revised PY - 2015/12/28/accepted PY - 2016/2/17/entrez PY - 2016/2/18/pubmed PY - 2016/8/23/medline KW - head and neck cancer KW - human p16 protein KW - papillomavirus infections KW - skin neoplasms KW - squamous cell neoplasms KW - unknown primary neoplasms SP - 1201 EP - 8 JF - Cancer JO - Cancer VL - 122 IS - 8 N2 - BACKGROUND: The incidence of p16 overexpression and the role of human papillomavirus (HPV) in cutaneous head and neck squamous cell carcinoma (cHNSCC) are unclear. METHODS: One hundred forty-three patients with cHNSCC lymph node metastases involving the parotid gland were evaluated for p16 expression by immunohistochemistry. The detection of 18 high-risk HPV subtypes was performed with HPV RNA in situ hybridization for a subset of 59 patients. The results were correlated with clinicopathological features and outcomes. RESULTS: The median follow-up time was 5.3 years. No differences were observed in clinicopathological factors with respect to the p16 status. p16 was positive, weak, and negative in 45 (31%), 21 (15%), and 77 cases (54%), respectively. No high-risk HPV subtypes were identified, regardless of the p16 status. The p16 status was not prognostic for overall (hazard ratio, 1.08; 95% confidence interval [CI], 0.85-1.36; P = .528), cancer-specific (hazard ratio, 1.12; 95% CI, 0.77-1.64; P = .542), or progression-free survival (hazard ratio, 1.03; 95% CI, 0.83-1.29; P = .783). Distant metastasis-free survival, freedom from locoregional failure, and freedom from local failure were also not significantly associated with the p16 status. CONCLUSIONS: p16 positivity is common but not prognostic in cHNSCC lymph node metastases. High-risk HPV subtypes are not associated with p16 positivity and do not appear to play a role in this disease. HPV testing, in addition to the p16 status in the unknown primary setting, may provide additional information for determining a putative primary site. SN - 1097-0142 UR - https://www.unboundmedicine.com/medline/citation/26881928/p16_positive_lymph_node_metastases_from_cutaneous_head_and_neck_squamous_cell_carcinoma:_No_association_with_high_risk_human_papillomavirus_or_prognosis_and_implications_for_the_workup_of_the_unknown_primary_ L2 - https://doi.org/10.1002/cncr.29901 DB - PRIME DP - Unbound Medicine ER -