Human papillomavirus and p53 expression in cancer of unknown primary in the head and neck region in relation to clinical outcome.
Bottom Line: Patients with HPV DNA-positive (HPVDNA+) metastases had significantly better 5-year overall survival (OS) compared to those with HPVDNA- metastases (80.0% vs. 36.7%, respectively; P = 0.004), with a similar tendency for disease-free survival (DFS).In addition, having absent/intermediary-low as compared to high expression of p53 correlated to a better prognosis with a 69% as compared to 14% 5-year OS, respectively (P < 0.001), and for DFS the tendency was analogous.In conclusion, both HPV status and p53 expression are valuable prognostic factors in patients with CUP in the head and neck region and should be further explored for clinical use.
Affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.Show MeSH
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Mentions: The 5-year OS rate in the entire cohort, regardless of HPV DNA status, was 54.0%. The 5-year OS rate was significantly higher in the group with HPVDNA+ metastases (80.0%) compared to that in the HPVDNA− group (36.7%) (P = 0.004, log-rank test; Fig. 2A). Likewise, 5-year OS for the HPVDNA+ group was higher as compared to the HPVDNA− group by univariate analysis, HR 0.236 (95% CI: 0.080–0.696, P = 0.009; Table 3). A similar tendency was demonstrated when HPV-positivity was defined as being positive for both HPV DNA and p16 and compared to the patients with either HPV DNA or p16-negative metastases (77.8% 5-year OS vs. 40.6% 5-year OS, respectively, P = 0.017, log-rank test). The two patients with HPVDNA+/p16-negative metastases both survived 5 years. The 5-year DFS was 85.0% in patients with HPVDNA+ metastases and 63.3% in patients with HPVDNA− metastases. This difference, however, did not reach statistical significance (P = 0.053, log-rank test).
Affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.