Association between loss of Y chromosome and poor prognosis in male head and neck squamous cell carcinoma

Abstract

Background

Head and neck squamous cell carcinoma (HNSCC) is more prevalent in men than women and this disparity cannot be fully explained by known risk factors. Recent studies have shown that loss of Y chromosome (LoY) confers an increased risk of solid cancer and reduces life expectancy in men.

Methods

Using publicly available data from The Cancer Genome Atlas, we investigated the prevalence of LoY and its association with clinicopathological features in male HNSCC.

Results

LoY was detectable in around 25% of male HNSCC. Men with human papillomavirus‐negative tumors exhibiting LoY experienced significantly worse overall survival than those with no LoY. Moreover, LoY tumors exhibited overexpression of genes involved in redox processes, including genes previously implicated in resistance to both radiotherapy and cisplatin‐based chemotherapeutics.

Conclusion

LoY may be an indicator of poor prognosis in male HNSCC that is linked to the overexpression of genes associated with resistance to standard care therapies.

http://bit.ly/2V1E61b

Failure patterns of head and neck squamous cell carcinoma treated with radical radiotherapy by intensity modulated radiotherapy technique using focal volume and dosimetric method

Abstract

Background

Labeling locoregional failures in head and neck cancer (HNC) as "local" and "regional" becomes incomplete when treating with intensity modulated radiotherapy (IMRT). Target delineation and delivery errors, dose in‐homogeneity complicate the assessment of failures. A combination of focal point and dosimetric method might attempt at simplifying failure analysis.

Methods

One hundred eleven patients with locally advanced HNC treated with chemoradiation using IMRT were enrolled. Patients with documented failure had their recurrence volume assessed using focal point and dosimetric method.

Results

With a median follow‐up of 20 (range 0‐39) months and median locoregional control (LRC) of 30 (range 24.8‐34.5) months, the patients had a 3‐year overall survival and LRC of 70.6% and 48.9%, respectively. Of 39 failures, there were 69.2%, 7.6%, 5.1%, 12.8%, and 5.1% type A, B, C, D, and E, respectively using the focal point and dosimetric method.

Conclusion

With the current classification, majority of the recurrences were high dose failures suggesting inherent radioresistance. While minority of failures were potentially preventable and needed modifying existing IMRT workflow.

http://bit.ly/2PZFc9Y

PD‐1 and PD‐L1 in locoregionally advanced nasopharyngeal carcinoma: A substudy of a randomized phase III trial

Abstract

Background

To evaluate the expression of programmed death‐1 (PD‐1) and programmed death‐ligand 1 (PD‐L1) by using immunohistochemistry analysis in locoregionally advanced nasopharyngeal carcinoma (NPC) patients receiving cisplatin, fluorouracil, and docetaxel followed by concurrent chemoradiotherapy.

Methods

As part of a previously reported trial, 108 patients were enrolled in this study.

Results

We observed that Epstein–Barr Virus (EBV) antibody levels were associated with PD‐1 positive staining in NPC and PD‐1 positive staining was identified as an independent prognostic factor for progression‐free survival (hazard ratio 0.363, 95% confidence interval 0.134‐0.987, P = .047). By contrast, the correlation between the PD‐L1 level and hemoglobin, lactate dehydrogenase and high‐sensitivity C‐reactive protein was not identified. Moreover, high levels of PD‐L1 staining were not significantly associated with clinical outcomes.

Conclusion

NPC patients with negative PD‐1 staining had a significantly reduced survival outcome. Furthermore, patients with positive PD‐1 staining had significantly higher EBV antibody levels.

http://bit.ly/2V8E1sk

Systematic review on location and timing of distant progression in human papillomavirus‐positive and human papillomavirus‐negative oropharyngeal squamous cell carcinomas

Abstract

Distant progression (DP) in oropharyngeal squamous cell carcinoma (OPSCC) has significant impact on morbidity and mortality. This study systematically reviewed the literature on studies reporting location and timing of DP after human papillomavirus (HPV)+ or HPV− OPSCCs. PubMed, EMBASE, and the Cochrane Library were systematically searched for studies reporting DP in patients treated with curative intend for an OPSCC. Outcome was site of and time to DP stratified on HPV‐status. Seven studies (n = 1564; 77% HPV+) were included in which 313 patients (20%) developed a DP (70% HPV+). The most common site of DP was the lungs (n = 232) regardless of HPV‐status. Patients with HPV+ tumors were more prone to dissemination involving multiple sites (risk ratio = 16.49). There was no difference in time to DP when stratified on HPV‐status (P = .10). The pattern of but not time to DP was significantly different in patients with OPSCC when stratified on HPV‐status.

http://bit.ly/2PWFle5

Prognostic implication of CEACAM1 expression in squamous cell carcinoma of the larynx: Pilot study

Abstract

Background

CEACAM1, a valuable biomarker for several cancers, have remained unexplored up to the present in laryngeal squamous cell carcinoma (LSCC). We aimed to examine CEACAM1 expression and evaluate its combinational clinical significance for the diagnosis or prognosis and treatment decision making in LSCC.

Methods

CEACAM1 expression was assessed by immunohistochemistry in 54 LSCCs and evaluate its correlation with clinical and histopathological features.

Results

CEACAM subtype 1 (CEACAM1) expression was positive in 50% of the cases. No significant difference was observed in relation to age, gender, tumor size, and tumor stage. CEACAM1 expression correlated with tumor grade, development of local recurrence, node and distant metastasis. Kaplan–Meier survival curves showed that CEACAM1 staining was inversely correlated with both overall and disease‐specific 5‐year survival.

Conclusions

Our study is the first to demonstrate that CEACAM1 expression is associated with an adverse prognosis in LSCC. CEACAM1 is a valuable biomarker and a promising therapeutic target in LSCC.

http://bit.ly/2V8drQg

De‐escalation of post‐treatment surveillance in oropharyngeal cancer

Abstract

Background

The majority of new oropharyngeal squamous cell carcinoma (OPSCC) cases are associated with human papillomavirus and favorable prognosis. Post‐treatment follow‐up should be targeted to patients at greatest risk for disease recurrence.

Methods

To assess the benefits of routine clinical surveillance in OPSCC, we reviewed all follow‐up visits conducted in 2014 at Helsinki University Hospital Department of Otorhinolaryngology.

Results

Of 366 visits, 26 (7%) were from patients presenting with a new symptom, and disease recurrence was detected in four. The presence of a new symptom was significantly associated with disease recurrence (P < 0.001). Of 366 visits, 340 (93%) were from patients presenting without new symptoms, and not a single recurrence was found during these visits.

Conclusions

Based on our findings, and previous studies assessing the prognosis and pattern of recurrent OPSCC, we concluded that the number of routine post‐treatment visits can be reduced. Follow‐up should rather focus on symptom‐directed examinations.

http://bit.ly/2Q1w98i

High‐risk human papillomavirus detection in oropharyngeal cancers: Comparison of saliva sampling methods

Abstract

Background

Accumulating evidence has suggested the utility of salivary oral rinse as a diagnostic fluid to detect oral human papillomavirus (HPV) DNA, but there are many methods for collecting saliva.

Methods

Salivary oral rinse and unstimulated whole mouth saliva samples were collected from 45 oropharyngeal cancer (OPC) patients.

Results

We show a positive correlation of HPV‐16 E2 (r = 0.95, P < 0.0001) and E6/7 (r = 0.93, P < 0.0001) relative copy number as well as HPV genotypes in both sample methods. There was a significant correlation between the two sample methods in the ratio of HPV16 E2 to E6/7 DNA (r = 0.46, P < 0.01). Consistent with previous studies, a mixed HPV‐16 form (episomal and integrated) was commonly found in both saliva and tumor samples.

Conclusion

Detection of HPV in saliva samples collected by either method yielded comparable results, and showed good sensitivity for detection of HPV derived from OPC.

http://bit.ly/2V71HgX