Human papillomavirus infection mediates response and outcome of vulvar squamous cell carcinomas treated with radiation therapy.
Gynecol Oncol
; 151(1): 96-101, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-30082072
ABSTRACT
PURPOSE:
Human papillomavirus (HPV) is implicated as a causative factor in vulvar squamous cell carcinoma (VSCC). This study evaluates if p16-positivity, a surrogate for HPV, predicts for better response rates to chemoradiation therapy and survival. MATERIALS ANDMETHODS:
We conducted a retrospective chart review of women treated with neoadjuvant or definitive chemoradiation (CRT) therapy from 2000 to 2016 for VSCC. p16 stain-positivity was defined as diffuse strong "block" immunoreactivity within invasive tumor.RESULTS:
Seventy-three women with median follow-up of 13.4â¯months were analyzed. Thirty-three (45.2%) had p16+ tumors. Median age was 73â¯years (range 37-89); with p16+ tumors, the median age was 60â¯years vs 73â¯years for women with p16- tumors (pâ¯<â¯0.001). The distribution of tumor size and stage by p16-status were similar. The complete clinical response (cCR) rate for p16+ tumors was 63.6% vs 35.0% for p16- tumors (pâ¯=â¯0.014). The pathologic complete response (pCR) rate for women treated neoadjuvantly was 53.8% vs 31.4% for p16+ vs p16-, respectively (pâ¯=â¯0.067). The combined complete response (cCR orpCR [CCR]) rate was 63.6% for p16+ and 30.0% for p16- (pâ¯=â¯0.004). Two-year vulvar control (VC) for women with p16+ tumors was 75.5% vs. 49.5% for p16- (pâ¯=â¯0.008). In women with p16+ tumors who achieved CCR, 2-year VC was 92.3% vs 52.1% for CIR (pâ¯=â¯0.009). For p16- tumors, 2-year VC was 67.3% vs 41.1% for CCR and CIR (pâ¯=â¯0.072). No woman with a p16+ tumor developed distant metastases vs. 7 with p16- tumor (pâ¯=â¯0.013). OS was not statistically different between p16+ cohorts, but was improved for p16- patients with CR vs CIR, 72.9% vs 18.8% (pâ¯=â¯0.026).CONCLUSIONS:
p16-positive tumors appear to have better clinical and pathologic response rates and clinical outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article