Head & neck 2016-04
Prognostic value of p16 expression in Epstein-Barr virus-positive nasopharyngeal carcinomas.
Abstract
Background
Overexpression of p16 is associated with improved outcomes among patients with oropharyngeal carcinoma. However, its role in the outcomes of patients with nasopharyngeal cancer (NPC) remains unclear.
Methods
Eighty-six patients with NPC treated at MD Anderson Cancer Center from 2000 to 2014 were identified. Epstein-Barr virus (EBV) and human papillomavirus (HPV) status were determined by in situ hybridization (ISH) and p16 by immunohistochemical staining.
Results
EBV positivity was associated with extended overall survival (OS; median, 95.0 vs 44.9 months; p < .004), progression-free survival (PFS; median, 80.4 vs 28.1 months; p < .013), and locoregional control (median, 104.4 vs 65.5 months; p < .043). In patients with EBV-positive tumors, p16 overexpression correlated with improved PFS (median, 106.3 vs 27.1 months; p < .02) and locoregional control (median, 93.6 vs 64.5 months; p < .02).
Conclusion
P16 overexpression is associated with improved PFS and locoregional control in patients with EBV-positive NPC. P16 expression may complement EBV status in predicting treatment outcomes for patients with NPC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1459-E1466, 2016.
Related Questions
What head and neck subsites would you treat for a SCC of multiple ipsilateral neck nodes (clinical ECE, no contralateral nodes) with unknown primary origin site despite full workup?
Oropharynx, bilateral neck, ipsilateral RP nodes, and nasopharynx. You could omit the NPX but you’re up there anyway to treat the RPs.
What mucosal surfaces do you commonly cover with HPV-positive squamous cell carcinoma of the head and neck of unknown primary?
This is an interesting question. Many radiation oncologists are eliminating the nasopharyngeal mucosa from the field when designing plans for “comprehensive mucosal irradiation” in cases of unknown primary head and neck cancers with HPV or p16 positive squamous histology. I am currently not comforta...