Does the better prognosis associated with p16+ H&N cancers relate only to patients who are treated with RT +/- chemo?
Does the better prognosis associated with p16+ H&N cancers relate only to patients who are treated with RT +/- chemo? Or do they do better in the post-op setting as well?
For example, would observation be reasonable in a p16+ 80 year old woman with a pT1 pN2a M0 tonsil cancer (post-op) where the 4.5 cm LN is the ONLY indication for post-op RT? (clear margins (albeit 2 mm deep margin at the tonsil), no PNI, no ECE, etc. Clearly, it would be nice to avoid RT in this otherwise healthy but elderly woman.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Michigan
Answered on
The good prognosis of HPV-related OPC pts is observed also in surgical series. Surprisingly, series of TORS find no ststistically differences in TORS for early stage HPV(+) or (-) pts (Cohen MA, Weisndtein Gs et al, Head and Neck 2011), and it is possible that surgical resection of HPV(-) cancers gr...
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Mednet MemberInvited Expert
Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on
There are 2 separate questions. Regarding the general question of prognosis, it seems that HPV/p16 association is a favorable prognosistic feature regardless of the mode of therapy. This has led to interest in answering questions in the HPV+ve patients such as if trimodality therapy is always necess...
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