Predictors for Survival of Patients with Squamous Cell Carcinoma of Unknown Primary in the Head and Neck Region

Steffen Wagner; Christine Langer; Nora Wuerdemann; Susanne Reiser; Helen Abing; Jörn Pons-Kühnemann; Elena-Sophie Prigge; Magnus von Knebel Doeberitz; Stefan Gattenlöhner; Tim Waterboer; Lea Schroeder; Christoph Arens; Jens Peter Klussmann; Claus Wittekindt

doi:10.3390/cancers15072167

Cancers (Apr 2023)

Predictors for Survival of Patients with Squamous Cell Carcinoma of Unknown Primary in the Head and Neck Region

Steffen Wagner,
Christine Langer,
Nora Wuerdemann,
Susanne Reiser,
Helen Abing,
Jörn Pons-Kühnemann,
Elena-Sophie Prigge,
Magnus von Knebel Doeberitz,
Stefan Gattenlöhner,
Tim Waterboer,
Lea Schroeder,
Christoph Arens,
Jens Peter Klussmann,
Claus Wittekindt

Affiliations

Steffen Wagner: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany
Christine Langer: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany
Nora Wuerdemann: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany
Susanne Reiser: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany
Helen Abing: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, 50937 Cologne, Germany
Jörn Pons-Kühnemann: Medical Statistics, Institute of Medical Informatics, University of Giessen, 35392 Giessen, Germany
Elena-Sophie Prigge: Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, 69120 Heidelberg, Germany
Magnus von Knebel Doeberitz: Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, 69120 Heidelberg, Germany
Stefan Gattenlöhner: Institute of Pathology, University of Giessen, 35392 Giessen, Germany
Tim Waterboer: Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
Lea Schroeder: Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
Christoph Arens: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany
Jens Peter Klussmann: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany
Claus Wittekindt: Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, 35392 Giessen, Germany

DOI: https://doi.org/10.3390/cancers15072167
Journal volume & issue: Vol. 15, no. 7
p. 2167

Abstract

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Background: Human papillomavirus (HPV) status is the most important predictor of survival in oropharyngeal squamous cell carcinoma (OPSCC). In patients with cervical lymph node metastases of squamous cell carcinoma of unknown origin (CUPHNSCC), much less is known. Methods: We assessed a consecutive cohort of CUPHNSCC diagnosed from 2000–2018 for HPV DNA, mRNA, p16INK4a (p16) expression, and risk factors to identify prognostic classification markers. Results: In 32/103 (31%) CUPHNSCC, p16 was overexpressed, and high-risk HPV DNA was detected in 18/32 (56.3%). This was mostly consistent with mRNA detection. In recursive partitioning analysis, CUPHNSCC patients were classified into three risk groups according to performance status (ECOG) and p16. Principal component analysis suggests a negative correlation of p16, HPV DNA, and gender in relation to ECOG, as well as a correlation between N stage, extranodal extension, and tobacco/alcohol consumption. Conclusions: Despite obvious differences, CUPHNSCC shares similarities in risk profile with OPSCC. However, the detection of p16 alone appears to be more suitable for the classification of CUPHNSCC than for OPSCC and, in combination with ECOG, allows stratification into three risk groups. In the future, additional factors besides p16 and ECOG may become important in larger studies or cases with special risk profiles.

Published in Cancers

ISSN: 2072-6694 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.mdpi.com/journal/cancers/

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