P16 status, pathologic and clinical characteristics, biomolecular signature, and long-term outcomes in head and neck squamous cell carcinomas of unknown primary

Lanea M. Keller, Thomas J. Galloway, Thomas Holdbrook, Karen Ruth, Donghua Yang, Cara Dubyk, Douglas Flieder, Miriam N. Lango, Ranee Mehra, Barbara Burtness, John A. Ridge

Research output: Contribution to journalArticle

Abstract

Background. The purpose of this study was to report associations between p16 status, clinicopathologic characteristics, and outcomes for head and neck squamous cell carcinoma of unknown primary (CUP).

Methods. Specimens of squamous cell CUP were reanalyzed. Human papillomavirus (HPV) status was determined by p16 stain. A tissue microarray (TMA) was constructed to evaluate biomarkers potentially prognostic in head and neck squamous cell carcinoma (HNSCC).

Results. A majority of the population (n=26; 74%) was p16 positive (1). Prognostic factors benefiting survival were p161 status (p<.0001), absence of macroscopic extracapsular extension (ECE; p=.004), younger age (p=.01), and higher grade (p=0.007). The prognostic implication of worse overall survival (OS) with macroscopic ECE (p = .009) remained significant when limited to patients who were p161 (p=.002). Exploratory TMA between unknown primary and controls suggested a biomolecular difference between squamous cell CUP and known-primary cancer.

Conclusion. The majority of patients with squamous cell CUP were p161, indicative of HPV association. P16 staining and ECE seem to be the most prognostic features in squamous cell CUP.

Original languageEnglish (US)
Pages (from-to)1677-1684
Number of pages8
JournalHead and Neck
Volume36
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Concurrent chemotherapy
  • Extracapsular extension (ECE)
  • Human papillomavirus (HPV)
  • Tissue microarray
  • Unknown primary

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Keller, L. M., Galloway, T. J., Holdbrook, T., Ruth, K., Yang, D., Dubyk, C., Flieder, D., Lango, M. N., Mehra, R., Burtness, B., & Ridge, J. A. (2014). P16 status, pathologic and clinical characteristics, biomolecular signature, and long-term outcomes in head and neck squamous cell carcinomas of unknown primary. Head and Neck, 36(12), 1677-1684. https://doi.org/10.1002/hed.23514