Human papillomavirus-related cell cycle markers can predict survival outcomes following a transoral lateral oropharyngectomy for tonsillar squamous cell carcinoma

J Surg Oncol. 2014 Sep;110(4):393-9. doi: 10.1002/jso.23672. Epub 2014 Jun 5.

Abstract

Objectives: To identify the prognostic implications of human papillomavirus (HPV)-related cell cycle marker profiles in patients who have received a transoral lateral oropharyngectomy (TLO) as a primary treatment for tonsillar squamous cell carcinoma (TSCC).

Patients and methods: Immunohistochemical profiles of HPV-related cell cycle markers, including p16, pRb, cyclin D1, p53, and the HPV DNA status of 42 consecutive TSCC patients who underwent TLO-based treatments were analyzed. The prognostic value of each marker was evaluated.

Results: Univariate analysis indicated that high p16, low pRb, and low p53 expression levels are significantly associated with a good disease-free and overall survival outcome. Clinicopathological parameters and the HPV DNA status did not show prognostic significance. When adjusted for age, overall stage and treatment strategy, a high p16 and low pRb level remained an effective prognostic marker for good survival outcomes. A high p16/low pRb combination showed superior survival prediction ability over high p16 or low pRb alone.

Conclusion: HPV-related cell cycle markers may also be good indicators for predicting survival after TLO for TSCC. The de-escalation TLO surgery approach would be more effective if performed under the stringent guidance of these markers.

Keywords: human papillomavirus; p16; pRb; squamous cell carcinoma; survival; tonsil.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / chemistry
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / virology
  • Cell Cycle
  • Cyclin D1 / analysis
  • Cyclin-Dependent Kinase Inhibitor p16
  • DNA, Viral / analysis
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Proteins / analysis
  • Oropharynx / surgery*
  • Papillomaviridae / isolation & purification*
  • Retinoblastoma Protein / analysis
  • Tonsillar Neoplasms / chemistry
  • Tonsillar Neoplasms / mortality
  • Tonsillar Neoplasms / surgery*
  • Tonsillar Neoplasms / virology
  • Tumor Suppressor Protein p53 / analysis

Substances

  • CCND1 protein, human
  • CDKN2A protein, human
  • Cyclin-Dependent Kinase Inhibitor p16
  • DNA, Viral
  • Neoplasm Proteins
  • Retinoblastoma Protein
  • Tumor Suppressor Protein p53
  • Cyclin D1