Prognostic impact of additional HPV-typing in p16-stratified advanced oropharyngeal squamous cell carcinoma

Background p16 is considered as surrogate marker for the identification of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCCs)

Methods: 102 patients with advanced stage (III - IVa) OPSCCs treated primarily by transoral lasermicrosurgery were included. p16- and HPV-status were evaluated by immunohistochemistry and genotyping, respectively, and analyzed for their stand alone or combined prognostic association.

Conclusions In contrast to p16, the HPV-status resulted in no significant survival discrepancies (five-year overall survival (OS) HPV^pos 65 % vs. HPV^neg 79 %, P = 0.462; p16^pos 83 % vs. p16^neg 63 %, P = 0.019). Combining both markers, p16^pos (p16^pos/HPV^pos, p16^pos/HPV^neg) and p16^neg/HPV^neg groups demonstrated comparable high survival (OS 78 % vs. 86 % vs. 74 %). Lowest survival was observed for patients with p16^neg/HPV^pos OPSCCs (OS 41 %, P = 0.016).

Considering further tobacco consumption, never smoking patients with p16^pos OPSCCs demonstrated the highest survival, whereas within former/current smokers with p16^pos and p16^neg disease it was comparable low (OS 90 % vs. 63 % vs. 57 %, P = 0.012).

Conclusion p16- and HPV-status should not be considered as equivalent markers for a better prognosis. Furthermore, patient associated factors like smoking should be included in clinical evaluation.

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Publication History

Article published online:
10 June 2020