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p16‐positive lymph node metastases from cutaneous head and neck squamous cell carcinoma: No association with high‐risk human papillomavirus or prognosis and implications for the workup of the unknown primary
Author(s) -
McDowell Lachlan J.,
Young Richard J.,
Johnston Meredith L.,
Tan TzeJian,
Kleid Stephen,
Liu Chen S.,
Bressel Mathias,
Estall Vanessa,
Rischin Danny,
Solomon Benjamin,
Corry June
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29901
Subject(s) - medicine , hazard ratio , oncology , immunohistochemistry , lymph node , head and neck squamous cell carcinoma , confidence interval , head and neck cancer , incidence (geometry) , human papillomavirus , cancer , physics , optics
BACKGROUND The incidence of p16 overexpression and the role of human papillomavirus (HPV) in cutaneous head and neck squamous cell carcinoma (cHNSCC) are unclear. METHODS One hundred forty‐three patients with cHNSCC lymph node metastases involving the parotid gland were evaluated for p16 expression by immunohistochemistry. The detection of 18 high‐risk HPV subtypes was performed with HPV RNA in situ hybridization for a subset of 59 patients. The results were correlated with clinicopathological features and outcomes. RESULTS The median follow‐up time was 5.3 years. No differences were observed in clinicopathological factors with respect to the p16 status. p16 was positive, weak, and negative in 45 (31%), 21 (15%), and 77 cases (54%), respectively. No high‐risk HPV subtypes were identified, regardless of the p16 status. The p16 status was not prognostic for overall (hazard ratio, 1.08; 95% confidence interval [CI], 0.85‐1.36; P = .528), cancer‐specific (hazard ratio, 1.12; 95% CI, 0.77‐1.64; P = .542), or progression‐free survival (hazard ratio, 1.03; 95% CI, 0.83‐1.29; P = .783). Distant metastasis‐free survival, freedom from locoregional failure, and freedom from local failure were also not significantly associated with the p16 status. CONCLUSIONS p16 positivity is common but not prognostic in cHNSCC lymph node metastases. High‐risk HPV subtypes are not associated with p16 positivity and do not appear to play a role in this disease. HPV testing, in addition to the p16 status in the unknown primary setting, may provide additional information for determining a putative primary site. Cancer 2016;122:1201–8 . © 2016 American Cancer Society .