INTRODUCTION Increasing incidence of head and neck cancer are reported worldwide, especially for
oropharyngeal squamous cell carcinomas (OPSCC) induced by human papillomavirus (HPV).
Due to a remarkably better prognosis, a de-escalation of the standard treatment for
patients with HPV-driven OPSCC has been proposed. p16INK4a (p16) is currently accepted as a surrogate for HPV in OPSCC staging. However, the
specificity rates have raised concerns about de-escalation when based solely on p16
expression, and experimental data on HPV prevalence in OPSCC are still insufficient.
MATERIAL AND METHODS We investigated HPV-DNA status, p16 expression and multiple tumor- and patient-related
risk factors in a consecutive cohort of OPSCC diagnosed between 2000 and 2017 and
compared our data with cancer registry databases.
RESULTS The HPV-attributable fraction comprises n=192 (27 % ) OPSCC with p16-expression and
positivity for high-risk HPV-DNA, in most cases (95 % ) HPV-type 16. The incidence
significantly increased in the oropharyngeal sub-sites tonsils and oropharynx, while
others did not change. This is reflected in cancer registry data, although there are
national differences.
In n=39 OPSCC, p16-expression without detectable HPV DNA was found. According to principal
component and survival analyses, 61 % of these cases, which represented 11 % of
total p16-positive cases, were not comparable to HPV-driven OPSCC in terms of risk
factor profile and overall survival.
Discussion The increasing incidence of HPV-driven OPSCC is undeniable in several countries.
Nevertheless, population-based studies of spatial heterogeneity and the role of HPV
in subpopulations, such as p16-positive but HPV-DNA negative OPSCC, which appear unsuitable
for treatment de-escalation, remain essential.
Poster-PDF
A-1476.pdf
Teile dieser Arbeit wurde durch das Investigator Studies Program (MISP, Fördernummer:
56606) von MSD Sharp & Dohme GmbH unterstützt.
