Wendt Malin, Hammarstedt-Nordenvall Lalle, Zupancic Mark, Friesland Signe, Landin David, Munck-Wikland Eva, Dalianis Tina, Näsman Anders, Marklund Linda
Department of Clinical Science, Intervention and Technology-CLINTEC Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Karolinska University Hospital, 171 64 Stockholm, Sweden.
Medical Unit Head Neck, Lung and Skin Cancer, Karolinska University Hospital, 171 76 Stockholm, Sweden.
Cancers (Basel). 2021 May 23;13(11):2553. doi: 10.3390/cancers13112553.
Long-term survival data in relation to sub-sites, human papillomavirus (HPV), and p16 (p16) for patients with oropharyngeal squamous cell carcinoma (OPSCC) is still sparse. Furthermore, reports have indicated atypical and late recurrences for patients with HPV and p16 positive OPSCC. Therefore, we assessed long-term survival and recurrence in relation to oropharyngeal subsite and HPV/p16 status. A total of 529 patients with OPSCC, diagnosed in the period 2000-2010, with known HPVDNA and p16-status, were included. HPV/p16 status and sub-sites were correlated to disease-free and overall survival (DFS and OS respectively). The overexpression of p16 (p16) is associated with significantly better long-term OS and DFS in tonsillar and base of tongue carcinomas (TSCC/BOTSCC), but not in patients with other OPSCC. Patients with HPVDNA/p16 TSCC/BOTSCC presented better OS and DFS compared to those with HPVDNA/p16 tumors, while those with HPVDNA/p16 cancer had an intermediate survival. Late recurrences were rare, and significantly more frequent in patients with p16 tumors, while the prognosis after relapse was poor independent of HPVDNA/p16 status. In conclusion, patients with p16 OPSCC do not have more late recurrences than p16, and a clear prognostic value of p16 was only observed in TSCC/BOTSCC. Finally, the combination of HPVDNA and p16 provided superior prognostic information compared to p16 alone in TSCC/BOTSCC.
口咽鳞状细胞癌（OPSCC）患者关于亚部位、人乳头瘤病毒（HPV）和p16的长期生存数据仍然稀少。此外，有报告指出HPV和p16阳性的OPSCC患者存在非典型和晚期复发情况。因此，我们评估了与口咽亚部位以及HPV/p16状态相关的长期生存和复发情况。纳入了2000年至2010年期间诊断的529例已知HPV DNA和p16状态的OPSCC患者。HPV/p16状态和亚部位与无病生存期和总生存期（分别为DFS和OS）相关。p16过表达与扁桃体癌和舌根癌（TSCC/BOTSCC）患者显著更好的长期OS和DFS相关，但在其他OPSCC患者中并非如此。与HPV DNA/p16阴性肿瘤患者相比，HPV DNA/p16阳性TSCC/BOTSCC患者的OS和DFS更好，而HPV DNA/p16阴性癌症患者的生存期处于中间水平。晚期复发很少见，在p16阴性肿瘤患者中明显更频繁，而复发后的预后与HPV DNA/p16状态无关，情况较差。总之，p16阳性的OPSCC患者的晚期复发并不比p16阴性患者多，并且仅在TSCC/BOTSCC中观察到p16具有明确的预后价值。最后，在TSCC/BOTSCC中，与单独的p16相比，HPV DNA和p16的联合提供了更好的预后信息。
