Implicación prónostica de la infección por virus del papiloma himano en tumores de orofaringe y cavidad oral localmente avanzados e irresecables

Abstract

Over the past decade, there has been a significant increase in the incidence of HPV positive head and neck cancers (HNC), particularly in tumors arising in the oropharynx, comprising approximately 60% of all cases. HPV positive represents a distinct molecular and clinical entity from HPV negative disease. HPV positivity is strongly correlated with a significantly superior outcome indicating that such tumors should have a distinct management approach. However, its prognostic impact on non-oropharyngeal tumors is not stablished. Current treatment regimens for unresectable, locally advanced, HNC are aggressive and several treatment strategies, including concomitant chemoradiotherapy, induction chemotherapy or anti-EGFR and radiotherapy are standard treatment options. Refining clinical and molecular features that separate HPV-associated and non-associated tumors will undoubtedly improve HNC management. Our research project was conducted in a total of 83 patients with diagnosis of unresectable, locally advanced oropharyngeal and oral cavity tumors. We have demonstrated the impact value of HPV positivity on progression free survival and overall survival, particularly in oropharyngeal cancer patients. The concordance of HPV-PCR and p16 immunohistochemistry diagnostic methods, was significant within the total patient population and similar to previous reports. Our gene expression studies demonstrated that Basal-Like signature correlated with poor prognosis, and also we were able to confirm several genes that were differently expressed within oral cavity and oropharyngeal tumors, without differences among HPV positive and negative tumors, probably due to the limited number of HPV positive patients enrolled in our study.

Date of Award	27 Sept 2017
Original language	Spanish
Supervisor	Jordi Giralt Lopez de Sagredo (Director) & Prat Aparicio Aleix (Director)