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Head Neck. 2013 Dec;35(12):1698-706. doi: 10.1002/hed.23231. Epub 2013 Mar 18.

Impact of p16, p53, smoking, and alcohol on survival in patients with oropharyngeal squamous cell carcinoma treated with primary intensity-modulated chemoradiation.

Author information

1
Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St.Gallen, Switzerland.

Abstract

BACKGROUND:

Analysis of the impact of risk factors on survival in patients with oropharyngeal squamous cell carcinoma (OPSCC) treated by primary intensity-modulated radiotherapy (IMRT).

METHODS:

One hundred forty patients were included with tissue microarray (TMA) construction and immunohistochemical analysis in 124 patients (87%).

RESULTS:

Survival analysis of patients classified into 3 risk categories according to an algorithm based on p16, smoking, T classification, and N classification revealed significant differences with a low, intermediate, and high-risk group. There was a significant impact of p53 expression as surrogate marker for smoking on outcome. In multivariate analysis, p16-positivity was a positive predictor and alcohol as well as N classification was a negative predictor for survival. The algorithm was modified based on alcohol instead of smoking with even more significant differences between the groups.

CONCLUSIONS:

A risk model based on multiple factors instead of p16 as single marker can define different risk groups to select patients for treatment deintensification in future prospective clinical trials.

KEYWORDS:

HPV; alcohol; intensity modulated radiotherapy; oropharyngeal squamous cell carcinoma; outcome; p16; p53; risk stratification; smoking; survival

PMID:
23508511
DOI:
10.1002/hed.23231
[Indexed for MEDLINE]

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