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Meta-analysis of survival in patients with HNSCC discriminates risk depending on combined HPV and p16 status.
- Source :
-
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2016 Aug; Vol. 273 (8), pp. 2157-69. Date of Electronic Publication: 2015 Jul 31. - Publication Year :
- 2016
-
Abstract
- Data indicate a better prognosis for human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC). HPV and p16 detection are established markers for HPV-related HNSCC. Both are accepted as survival-independent predictors. Previous studies investigating the survival in HNSCC patients depending on HPV(+/-) and p16(+/-) status consistently found discordant results with p16(-)/HPV(+) and p16(+)/HPV(-). However, no meta-analysis regarding the survival according to combined HPV/p16 status has been performed yet. The objective of this study was to discriminate the impact of combined HPV(+/-) and p16(+/-) status on survival. Data sources were identification and review of publications assessing survival of the distinct subgroups with both p16 and HPV investigated in HNSCC until February, 2015. A meta-analysis was performed to classify survival and clinical outcomes. 18 out of 397 articles (4424 patients) were eligible for the meta-analysis. The percent proportion of the subgroups was 25 % for HPV(+)/p16(+), 61.2 % for HPV(-)/p16(-), 7.1 % for HPV(-)/p16(+) and 6.8 % for HPV(+)/P16(-). The meta-analysis showed a significantly improved 5-year overall survival (OS), 5-year disease-free survival and their corresponding hazard ratio for HPV(+)/p16(+) HNSCC in comparison to HPV(-)/p16(-), HPV(+)/p16(-) and HPV(-)/p16(+). The 5-year OS of the HPV(-)/p16(+) subgroup was intermediate while HPV(+)/p16(-) and HPV(-)/p16(-) HNSCC had the shortest survival. With current therapeutic strategies, survival of patients with HNSCC is better if associated with HPV(+)/p16(+) or HPV(-)/p16(+). Clinical trials are needed to confirm the distinct survival pattern and to investigate possible differences in survival for HPV(+)/p16(-) and HPV(-)/p16(+) HNSCC. To further differentiate p16(+) HNSCC, HPV testing may be advisable.
- Subjects :
- Carcinoma, Squamous Cell genetics
Carcinoma, Squamous Cell pathology
Carcinoma, Squamous Cell virology
Disease-Free Survival
Female
Head and Neck Neoplasms complications
Head and Neck Neoplasms genetics
Head and Neck Neoplasms virology
Humans
Male
Papillomaviridae
Papillomavirus Infections virology
Prognosis
Publication Bias
Risk
Carcinoma, Squamous Cell mortality
Genes, p16
Head and Neck Neoplasms mortality
Papillomavirus Infections complications
Subjects
Details
- Language :
- English
- ISSN :
- 1434-4726
- Volume :
- 273
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 26227616
- Full Text :
- https://doi.org/10.1007/s00405-015-3728-0