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Keller LM , Galloway TJ , Holdbrook T , Ruth K , Yang D , Dubyk C , Flieder D , Lango MN , Mehra R , Burtness B , Ridge JA
p16 status, pathologic and clinical characteristics, biomolecular signature, and long-term outcomes in head and neck squamous cell carcinomas of unknown primary
Head Neck. 2014 Dec;36(12) :1677-84
PMID: 24115269 PMCID: PMC3972378
AbstractBACKGROUND: 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 (+). Prognostic factors benefiting survival were p16+ 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 p16+ (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 p16+, indicative of HPV association. P16 staining and ECE seem to be the most prognostic features in squamous cell CUP.
NotesKeller, Lanea M Galloway, Thomas J Holdbrook, Thomas Ruth, Karen Yang, Donghua Dubyk, Cara Flieder, Douglas Lango, Miriam N Mehra, Ranee Burtness, Barbara Ridge, John A P30 CA006927/CA/NCI NIH HHS/United States Research Support, N.I.H., Extramural United States Head Neck. 2014 Dec;36(12):1677-84. doi: 10.1002/hed.23514. Epub 2014 Jan 13.