dc.contributor.author | Craig, SG | |
dc.contributor.author | Anderson, LA | |
dc.contributor.author | Schache, AG | |
dc.contributor.author | Moran, M | |
dc.contributor.author | Graham, L | |
dc.contributor.author | Currie, K | |
dc.contributor.author | Rooney, K | |
dc.contributor.author | Robinson, M | |
dc.contributor.author | Upile, NS | |
dc.contributor.author | Brooker, R | |
dc.contributor.author | Mesri, M | |
dc.contributor.author | Bingham, V | |
dc.contributor.author | McQuaid, S | |
dc.contributor.author | Jones, T | |
dc.contributor.author | McCance, DJ | |
dc.contributor.author | Salto-Tellez, M | |
dc.contributor.author | McDade, SS | |
dc.contributor.author | James, JA | |
dc.date.accessioned | 2020-08-28T09:44:04Z | |
dc.date.issued | 2019-04-16 | |
dc.identifier.citation | British journal of cancer, 2019, 120 (8), pp. 827 - 833 | |
dc.identifier.issn | 0007-0920 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/4052 | |
dc.identifier.eissn | 1532-1827 | |
dc.identifier.doi | 10.1038/s41416-019-0414-9 | |
dc.description.abstract | BACKGROUND: TNM8 staging for oropharyngeal squamous cell carcinomas (OPSCC) surrogates p16 immunohistochemistry for HPV testing. Patients with p16+ OPSCC may lack HPV aetiology. Here, we evaluate the suitability of TNM8 staging for guiding prognosis in such patients. METHODS: HPV status was ascertained using p16 immunohistochemistry and high-risk HPV RNA and DNA in situ hybridisation. Survival by stage in a cohort of OPSCC patients was evaluated using TNM7/TNM8 staging. Survival of p16+/HPV- patients was compared to p16 status. RESULTS: TNM8 staging was found to improve on TNM7 (log rank p = 0·0190 for TNM8 compared with p = 0·0530 for TNM7) in p16+ patients. Patients who tested p16+ but were HPV- (n = 20) had significantly reduced five-year survival (33%) compared to p16+ patients (77%) but not p16- patients (35%). Cancer stage was reduced in 95% of p16+/HPV- patients despite having a mortality rate twice (HR 2.66 [95% CI: 1.37-5.15]) that of p16+/HPV+ patients under new TNM8 staging criteria. CONCLUSION: Given the significantly poorer survival of p16+/HPV- OPSCCs, these data provide compelling evidence for use of an HPV-specific test for staging classification. This has particular relevance in light of potential treatment de-escalation that could expose these patients to inappropriately reduced treatment intensity as treatment algorithms evolve. | |
dc.format | Print-Electronic | |
dc.format.extent | 827 - 833 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | SPRINGERNATURE | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | |
dc.subject | Humans | |
dc.subject | Papillomavirus Infections | |
dc.subject | Oropharyngeal Neoplasms | |
dc.subject | Viral Proteins | |
dc.subject | Neoplasm Staging | |
dc.subject | Disease-Free Survival | |
dc.subject | Gene Expression Regulation, Neoplastic | |
dc.subject | Adolescent | |
dc.subject | Adult | |
dc.subject | Middle Aged | |
dc.subject | Child | |
dc.subject | Child, Preschool | |
dc.subject | Infant | |
dc.subject | Infant, Newborn | |
dc.subject | Female | |
dc.subject | Male | |
dc.subject | Young Adult | |
dc.title | Recommendations for determining HPV status in patients with oropharyngeal cancers under TNM8 guidelines: a two-tier approach. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2019-02-06 | |
rioxxterms.versionofrecord | 10.1038/s41416-019-0414-9 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2019-04 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | British journal of cancer | |
pubs.issue | 8 | |
pubs.notes | Not known | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Molecular Pathology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Molecular Pathology/Integrated Pathology | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Molecular Pathology | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Molecular Pathology/Integrated Pathology | |
pubs.publication-status | Published | |
pubs.volume | 120 | |
pubs.embargo.terms | Not known | |
icr.researchteam | Integrated Pathology | |
dc.contributor.icrauthor | Salto-Tellez, Manuel | |