Which characteristics can be expected from p16⁺-squamous cell carcinomas of the posterior oral cavity and oropharynx? – Distinctive results from Central Germany - 19/11/19

Doi : 10.1016/j.jormas.2019.10.013

P. Pitak-Arnnop ^a,^b,⁎, ^{^{1
Equally contributed.}} , L.-K. Witohendro ^c,^{^{1
Equally contributed.}}, J.-P. Meningaud ^d, K. Subbalekha ^e, A. Iamaroon ^f, N. Sirintawat ^g, A. Klaisiri ^h, A. Neff ^b
^a Division of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Department of Trauma Surgery, Ortenau Medical Centre-Academic Teaching Hospital of Albert-Ludwigs University Freiburg, 77654 Offenburg, Germany
^b Department of Oral and Maxillofacial Surgery, UKGM GmbH, University Hospital of Marburg, Faculty of Medicine, Philipps University, Marburg, Germany
^c Faculty of Medicine, Goethe University, Frankfurt am Main, Germany
^d Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Faculty of Medicine, University Paris-Est Créteil Val de Marne (Paris XII), Henri Mondor University Hospital, AP–HP, Créteil, France
^e Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
^f Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
^g Formerly, Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany
^h Divisions of Operative Dentistry and Material Science, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand

^⁎Corresponding author. Sektion Plastische, Ästhetische und MKG-Chirurgie,Unfallklinik, Ortenau Klinikum Offenburg, Eberplatz 12, D-77654 Offenburg, Germany.Sektion Plastische, Ästhetische und MKG-Chirurgie,Unfallklinik, Ortenau Klinikum Offenburg, Eberplatz 12OffenburgD-77654Germany

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 19 November 2019
This article has been published in an issue click here to access

Abstract

Purpose

Human papillomaviruses (HPV) link to a subset of head and neck squamous cell carcinomas (HNSCC). Our aim was to identify clinicopathological characteristics (CPC) of squamous cell carcinomas of the posterior oral cavity and oropharynx (SCCPOCO) associated with HPV p16⁺.

Methods

Using a retrospective cohort study design, we enrolled a sample of SCCPOCO patients treated in a Central German hospital over a 3-year period. The predictor variables: CPCs, were grouped into demographic, social, anatomic and prognostic. The main outcome variable was p16⁺. Appropriate statistics were computed, and P≤0.05 was considered statistically significant.

Results

Of 199 HNSCC patients, 23 had SCCPOCO and entered the analysis (mean age, 67±12 years; 4 females; 16 in stage I; 4 p16⁺; 22 underwent primary surgery). We found 8 cervical lymph node metastases (34.8%), 3 distant metastases (13%), 9 recurrences (30.1%) and 3 overall deaths (13%). With the exception of recurrence (P=0.006) and overall death (P=0.02), p16⁺ was not associated with predictor variables: young age, male gender, smoking, alcohol consumption, tumor location, TNM stages, time to recurrence, metastases, death from disease and survival of smokers (P>0.05). Primary brachytherapy failed to improve survival of p16⁺-SCCPOCO patients (P=0.04).

Conclusions

The results of this study suggest that p16⁺- and p16^--SCCPOCOs in Central Germany share similar CPCs, except recurrence and overall death. Upfront surgery with/without radio(chemo)therapy is recommended for all operable SCCPOCOs, regardless of HPV-status. Patients with p16⁺-SCCPOCOs require close follow-up. Future research should investigate the cause of these distinctive CPCs.

El texto completo de este artículo está disponible en PDF.

Keywords : Human papillomavirus, Oral cavity, Oropharynx, Squamous cell carcinoma, Surgery, Germany