Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020
p16-expression are implemented in the TNM8 classification of oropharyngeal cancer (OPSCC). Based on a nationwide cohort, we provide a detailed description of subsite variation in the age-standardised incidence-rates of OPSCC alongside an evaluation of the prognostic impact of p16-expression accordin...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2025-08-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/44027 |
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| author | Pernille Lassen Jan Alsner Hanne Primdahl Christina Caroline Plaschke Christian Maare Jørgen Johansen Maria Andersen Mohammad Farhadi Jens Overgaard |
| author_facet | Pernille Lassen Jan Alsner Hanne Primdahl Christina Caroline Plaschke Christian Maare Jørgen Johansen Maria Andersen Mohammad Farhadi Jens Overgaard |
| author_sort | Pernille Lassen |
| collection | DOAJ |
| description | p16-expression are implemented in the TNM8 classification of oropharyngeal cancer (OPSCC). Based on a nationwide cohort, we provide a detailed description of subsite variation in the age-standardised incidence-rates of OPSCC alongside an evaluation of the prognostic impact of p16-expression according to subsite after primary radiotherapy (RT).
Patient/material and methods: A total of 8,462 Danish OPSCC patients from 1986 to 2020 were identified in the DAHANCA-database, and tumours were grouped into ‘tonsil/base of tongue (BOT)’, ‘neighbouring subsites’ and ‘distant subsites’. Subsite-specific age-standardised incidence-rates were calculated, and outcome-analysis (loco-regional control, disease-free survival and overall-survival 5 years after the completion of RT) stratified by p16-status/subsite and restricted to curatively treated patients only (N = 3,387) was performed.
Results: A 5-fold increase in the age-standardised incidence of OPSCC was observed and could be ascribed to the rise in p16-positive tumours of tonsil/BOT and neighbouring subsites only as neither the incidence rates nor the proportion of p16-positivity in distant subsites tumours changed over time. The prognostic impact of p16-status for all endpoints differed significantly across tumour subsites with the strongest association found in tonsil/BOT tumours, a diminishing but still significant impact in neighbouring subsite tumours and no significant impact in tumours arising in distant subsites.
Interpretation: Our findings suggest that grouping all p16-positive OPSCC as one entity for staging and prognostication, as currently done in TNM8, is too simple as it does not accurately depict the differences in tumour biology and the consequent treatment response.
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| format | Article |
| id | doaj-art-90c847b8bcc64912b8fec2725f2f7bd8 |
| institution | Kabale University |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-90c847b8bcc64912b8fec2725f2f7bd82025-08-20T04:01:26ZengMedical Journals SwedenActa Oncologica1651-226X2025-08-016410.2340/1651-226X.2025.44027Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020Pernille Lassen0https://orcid.org/0000-0003-1050-7692Jan Alsner1https://orcid.org/0000-0002-5395-3193Hanne Primdahl2https://orcid.org/0000-0003-3562-0026Christina Caroline Plaschke3https://orcid.org/0000-0002-4284-9040Christian Maare4https://orcid.org/0000-0002-9698-2082Jørgen Johansen5https://orcid.org/0000-0003-3911-3929Maria Andersen6Mohammad Farhadi7Jens Overgaard8https://orcid.org/0000-0002-0814-8179Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Oncology, Herlev Hospital, Copenhagen University, Herlev, DenmarkDepartment of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Oncology, Aarhus University Hospital, Aarhus, DenmarkDepartment of ENT, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Oncology, Herlev Hospital, Copenhagen University, Herlev, DenmarkDepartment of Oncology, Odense University Hospital, Odense, DenmarkDepartment of Oncology, Aalborg University Hospital, Aalborg, DenmarkDepartment of Oncology, Næstved Hospital, Næstved, DenmarkDepartment of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmarkp16-expression are implemented in the TNM8 classification of oropharyngeal cancer (OPSCC). Based on a nationwide cohort, we provide a detailed description of subsite variation in the age-standardised incidence-rates of OPSCC alongside an evaluation of the prognostic impact of p16-expression according to subsite after primary radiotherapy (RT). Patient/material and methods: A total of 8,462 Danish OPSCC patients from 1986 to 2020 were identified in the DAHANCA-database, and tumours were grouped into ‘tonsil/base of tongue (BOT)’, ‘neighbouring subsites’ and ‘distant subsites’. Subsite-specific age-standardised incidence-rates were calculated, and outcome-analysis (loco-regional control, disease-free survival and overall-survival 5 years after the completion of RT) stratified by p16-status/subsite and restricted to curatively treated patients only (N = 3,387) was performed. Results: A 5-fold increase in the age-standardised incidence of OPSCC was observed and could be ascribed to the rise in p16-positive tumours of tonsil/BOT and neighbouring subsites only as neither the incidence rates nor the proportion of p16-positivity in distant subsites tumours changed over time. The prognostic impact of p16-status for all endpoints differed significantly across tumour subsites with the strongest association found in tonsil/BOT tumours, a diminishing but still significant impact in neighbouring subsite tumours and no significant impact in tumours arising in distant subsites. Interpretation: Our findings suggest that grouping all p16-positive OPSCC as one entity for staging and prognostication, as currently done in TNM8, is too simple as it does not accurately depict the differences in tumour biology and the consequent treatment response. https://medicaljournalssweden.se/actaoncologica/article/view/44027Oropharyngeal cancer, HPV, subsite, TNM8 classification, radiotherapy, prognosis |
| spellingShingle | Pernille Lassen Jan Alsner Hanne Primdahl Christina Caroline Plaschke Christian Maare Jørgen Johansen Maria Andersen Mohammad Farhadi Jens Overgaard Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020 Acta Oncologica Oropharyngeal cancer, HPV, subsite, TNM8 classification, radiotherapy, prognosis |
| title | Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020 |
| title_full | Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020 |
| title_fullStr | Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020 |
| title_full_unstemmed | Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020 |
| title_short | Subsite variation of HPV-related p16-expression in oropharynx cancer: Incidence and prognostic impact in a population-based DAHANCA cohort 1986–2020 |
| title_sort | subsite variation of hpv related p16 expression in oropharynx cancer incidence and prognostic impact in a population based dahanca cohort 1986 2020 |
| topic | Oropharyngeal cancer, HPV, subsite, TNM8 classification, radiotherapy, prognosis |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/44027 |
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