Abstract
OBJECTIVES: Human Papillomavirus (HPV) may be a predictive biomarker predictor for clinical outcome and influence treatment decisions in patients with Head and Neck Squamous Cell Carcinoma (HNSCC). METHODS: We evaluated 253 patients with HNSCC from state of São Paulo, Brazil. The influence of p16(INK4a) expression was analyzed with epidemiological and clinical variables. RESULTS: In total, 32.4% of tumors studied had positive (+) p16(INK4a) protein expression, and 67.6% had negative. The variables were similar in both groups being the mostly with age under 64-years, male, white race, functional illiterate, smokers and alcoholics. The most affected primary site was oral cavity with T3/T4 tumoral stage, N1/N2/N3 nodals, M0 metastasis and III/IV clinical stage. Patients with oropharyngeal primary site and (+) p16(INK4a), clinical staging III and chemotherapy treatment had worse survival. The median time of distant metastasis-free was 38.3-months in oropharyngeal (+) p16(INK4a) and 15.1-months in negative (-) p16(INK4a). CONCLUSION: In the present study, the epidemiological variables are similar in both groups (Positive and negative p16(INK4a) expression): age under 64-years, male, white, functionally illiterate, smokers and alcoholics. There is no association of p16(INK4a) expression with primary site, however, the (-) p16(INK4a) shows better overall survival, higher frequencies in distant metastasis and less free time of the disease. Although the literature shows a greater survival in oropharynx (+) p16(INK4a), our results are contradictory. It is suggested that future studies in different regions and with a larger sample size should be carried out to confirm these findings, because the patients who participated in the present study are only from a specific region of Brazil. LEVEL OF EVIDENCE: 2B.