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Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Serhan HA, Sharma RK, Sharma D, Arora M, Rustagi S, Na A, Alsayyah A, Al-Hajeili M, Al-Subaie MF, Alfaresi M, Alissa M, Rabaan AA. Prevalence of human papillomavirus in head and neck cancer patients in India: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:516. [PMID: 38783184 PMCID: PMC11112865 DOI: 10.1186/s12879-024-09357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is increasingly recognized as a significant risk factor in the development of head and neck cancers (HNCs), with varying prevalence and impact. This study aims to systematically review and analyze the prevalence of HPV in HNCs in India, providing insights into regional variations. METHODS A comprehensive literature search was carried out using PubMed, Embase, and Web of Science up to November 10, 2023. Inclusion criteria focused on original research reporting HPV-positive cases among HNC patients in India. We used Nested-Knowledge software, for screening, and data extraction. The modified Newcastle-Ottawa Scale was used for quality assessment of included studies. We pooled the prevalence of HPV among HNC patients and performed a random-effects model meta-analysis using R software (version 4.3). RESULTS The search yielded 33 studies, encompassing 4654 HNC patients. The pooled prevalence of HPV infection was found to be 33% (95% CI: 25.8-42.6), with notable heterogeneity (I² = 95%). Analysis of subgroups according to geographical location indicated varying prevalence rates. Specifically, the prevalence was 47% (95% CI: 32.2-62.4) in the eastern regions and 19.8% (95% CI: 10.8-33.4) in the western regions. No evidence of publication bias was detected. CONCLUSION The observed considerable regional disparities on the prevalence of HPV in HNC patients in India emphasizes the need for integrated HPV vaccination and screening programs in public health strategies. The findings underline the necessity for further research to explore regional variations and treatment responses in HPV-associated HNCs, considering the impact of factors such as tobacco use and the potential benefits of HPV vaccination.
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Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospital, Saveetha University, Chennai, India.
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq.
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- Global South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.
| | - Rakesh Kumar Sharma
- Graphic Era (Deemed to be University), Clement Town, Dehradun, India
- Graphic Era Hill University, Clement Town, Dehradun, India
| | - Divya Sharma
- Centre of Research Impact and Outcome, Chitkara University, Rajpura, 140417, Punjab, India
| | - Mithhil Arora
- Chitkara Centre for Research and Development, Chitkara University, Himachal Pradesh, 174103, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - AlKaabi Na
- College of Medicine and Health Science, Khalifa University, 127788, Abu Dhabi, United Arab Emirates
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), 51900, Abu Dhabi, United Arab Emirates
| | - Ahmed Alsayyah
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
| | - Marwan Al-Hajeili
- Department of Medicine, College of Medicine, King Abdulaziz University, 23624, Jeddah, Saudi Arabia
| | - Maha F Al-Subaie
- Research Center, Dr. Sulaiman Alhabib Medical Group, 13328, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, 11533, Riyadh, Saudi Arabia
| | - Mubarak Alfaresi
- Department of Microbiology, National Reference laboratory, Cleveland clinic Abu Dhabi, 92323, Abu Dhabi, United Arab Emirates
- Department of Pathology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, 505055, Dubai, United Arab Emirates
| | - Mohammed Alissa
- Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, 11942, Al-Kharj, Saudi Arabia
| | - Ali A Rabaan
- College of Medicine, Alfaisal University, 11533, Riyadh, Saudi Arabia
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, 31311, Dhahran, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, 22610, Haripur, Pakistan
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Vani NV, Rama R, Madhanagopal R, Vijayalakshmi R, Swaminathan R. Human Papillomavirus-Attributable Head and Neck Cancers in India-A Systematic Review and Meta-Analysis. JCO Glob Oncol 2024; 10:e2300464. [PMID: 38513185 PMCID: PMC10965205 DOI: 10.1200/go.23.00464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE Head and neck cancer accounts for about one third of the global burden in India. Mucosal high-risk human papillomavirus (HPV) has been hypothesized as a contributory risk factor for head and neck cancer (HNC) but its prevalence in Indian patients is not well established. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HPV in HNC in India and their attributable fraction by considering the biomarkers of carcinogenesis, p16, and HPV E6/E7 mRNA. METHODS A systematic literature search was done in Medline via PubMed, Embase, Scopus, ScienceDirect, ProQuest, and Cochrane to identify studies on HPV and HNC in the Indian population, published between January 1990 and October 2022. Fifty-four eligible studies were identified and relevant clinical information was collected. Meta-analysis was conducted to estimate the pooled prevalence of HPV DNA, p16INK4a, and E6/E7 mRNA percent positivity by random-effect logistic regression model using Metapreg, STATA 18. RESULTS Thirty-four high-quality studies were taken for meta-analysis. The pooled prevalence of HPV in HNC was 20% (95% CI, 12 to 32) with a high level of heterogeneity (I2 = 90.79%). The proportion of HPV in oropharyngeal cancer (OPC; 22% [95% CI, 13 to 34]) and laryngeal cancer (LC; 29% [95% CI, 17 to 46]) was higher than in oral cancer (OC; 16% [95% CI, 8 to 30]). The HPV-attributable fraction of OPC, considering the E6/E7 mRNA and p16 positivity, was 12.54% and 9.68%, respectively, almost similar to LC (11.6% and 9.57%), while it was much lower in OC (3.36% and 4%). CONCLUSION The HPV-attributable fraction is considerably lower for OC, suggesting a negligible causative role of HPV in OC. A significant proportion of OPC and LC are attributed to HPV; however, their exact causative role is unclear because of the presence of other known risk factors.
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Affiliation(s)
| | - Ranganathan Rama
- Department of Epidemiology, Biostatistics and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - Rajendran Madhanagopal
- Department of Epidemiology, Biostatistics and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | | | - Rajaraman Swaminathan
- Department of Epidemiology, Biostatistics and Tumour Registry, Cancer Institute (WIA), Chennai, India
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Cui M, Cheng J, Cheng H, Zhao M, Zhou D, Zhang M, Jia J, Luo L. Characteristics of human papillomavirus infection among oropharyngeal cancer patients: A systematic review and meta-analysis. Arch Oral Biol 2024; 157:105830. [PMID: 37924712 DOI: 10.1016/j.archoralbio.2023.105830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE This study aimed to explore the characteristics of human papillomavirus (HPV) in oropharyngeal carcinoma (OPC), in order to provide a new theoretical basis for the prevention, treatment, and management of OPC. METHODS The electronic databases were searched available publications relevant to HPV infection and OPC. Studies were collected until July, 2023. The effect sizes were combined using R 4.2.2 software. Subgroup and sensitivity analyses were performed to explore the sources of heterogeneity. Funnel plot and Egger's test were used to assess the publication bias. RESULTS Seventy-one studies were included with 10,908 OPC patients. The pooled prevalence of HPV and HR-HPV infection was 44.22% and 43.94%, respectively. The genotypes of HR-HPV were HPV16 (37.24%), HPV33 (2.44%), HPV18 (1.64%), HPV35 (1.53%), and HPV58 (0.89%). The highest HPV infection was in North America (66.87%), Oceania (43.09%), and Europe (41.49%), lowest in Africa (4.89%). Females exhibited higher HPV infection (43.18% vs 34.59% in males). Top subsites of HPV infection was tonsil (45.78%), followed by base of tongue (36.66%). Infection was higher in OPC patients aged > 60 (38.15%) than < 60 (34.73%). The prevalence of HPV infection in stage I-II of OPC patients is higher than that in stage III-IV. CONCLUSIONS HPV genotyping (16, 18, 33, 35, 58) is a key factor in the prevention and treatment of OPC. Identifying tonsils, base of tongue, and soft palate as common subsites to improve early detection. Elderly women with high HPV infection require attention to risk management and health education for prevention.
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Affiliation(s)
- Meimei Cui
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; Department of Pathology, Weifang Medical University, Weifang, China
| | - Jinling Cheng
- Digestive Department, Shandong Second Provincial General Hospital, Jinan, China
| | - Huijuan Cheng
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Ming Zhao
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; School of Public Health, Jiamusi University, Jiamusi, China
| | - Dan Zhou
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; School of Public Health, Jiamusi University, Jiamusi, China
| | - Min Zhang
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; School of Public Health, Jiamusi University, Jiamusi, China
| | - Jingjing Jia
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; Department of Basic medicine, Jiamusi University, China
| | - Limei Luo
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China.
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Chaudhary V, Chaudhary N, Mathews S, Singh RD. Human Papilloma Virus-Associated Oral Pharyngeal Squamous Cell Carcinoma: Prevalence, Prevention, and Awareness of Vaccination in the Indian Population. Crit Rev Oncog 2023; 28:63-72. [PMID: 37830216 DOI: 10.1615/critrevoncog.2023048944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Human papilloma virus (HPV), one of the most common sexually transmitted infections, plays a pivotal role in head and neck cancer, primarily oral and oropharyngeal squamous cell carcinomas. HPV is a vaccine-preventable disease that also contributes to cervical cancer. Although HPV vaccination effectively protects the individual against all HPV-associated human carcinomas, the awareness of HPV vaccination and its acceptance is poor in developing nations like India. India has a very high burden of oral cancer, and, unfortunately, the morbidity and mortality rates are also high as the cancer is often detected at an advanced stage. In this review, we explore the prevalence of HPV-associated head and neck squamous cell carcinoma among the Indian population and the awareness of HPV vaccination among Indian youth. Since the prognosis for HPV-associated head and neck squamous cell carcinoma is good, early diagnosis of the cancer is crucial in improving the outcome of the treatment modalities. Efforts are needed to create and increase awareness of HPV vaccination. Routine screening for HPV infection in oral mucosa can prevent the silent epidemic from taking the lives of many young people.
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Affiliation(s)
- Vigi Chaudhary
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | - Naveen Chaudhary
- Department of Endodontics and Conservative Dentistry, Jaipur Dental College, Jaipur, India
| | | | - Ragini D Singh
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rajkot, Gujarat, India
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Ghoshal S, Dracham CB, Sundaram A, Kumar R, Bal A, Das A, Bahl A, Verma RK, Elangovan A. Prognostic Value of HPV Infection Assessed by p16 Immunohistochemistry and the Influence of Tobacco Usage in Oropharyngeal Cancers: Real World Scenario. Indian J Otolaryngol Head Neck Surg 2022; 74:5823-5831. [PMID: 36742604 PMCID: PMC9895501 DOI: 10.1007/s12070-021-02427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/25/2021] [Indexed: 02/07/2023] Open
Abstract
To find if an association could be established between Human Papilloma Virus (HPV) infection and oropharyngeal cancers (OPCs) in a group of patients known to be regular users of tobacco, and to determine the impact of HPV status on clinical outcomes.Case records of 212 patients with AJCC-7 (The American Joint Committee on Cancer 7th edition) stages II-IVB non metastatic squamous cell carcinoma of the oropharynx treated using radical radiotherapy with or without chemotherapy during the years 2015-2018 were retrieved. Formalin-fixed, paraffin-embedded blocks from oropharyngeal biopsies were available for 177 patients and were evaluated for p16 expression by immunohistochemical (IHC) staining. More than 50% nuclear staining with or without cytoplasmic staining was considered HPV+ . The association between tobacco use and HPV, as well as the influence of HPV status on survival outcomes were assessed. p16 expression was found to be positive in 23(13%) patients. Significant association was found between chewable tobacco usage and HPV positivity (p = 0.051). The median follow up was 20.5 months (range: 3-80). 5-year Overall Survival was 43.4% and 29.8% (p = 0.044) in HPV+ and HPV- patients, respectively. Local control was significantly better in HPV+ patients (38.6% vs. 25.3%, p = 0.049). There was also a trend towards improved Disease-free Survival in HPV+ patients (31 months vs. 15 months, p = 0.078). Though less in prevalence among the Indian population, improved outcomes in HPV+ OPC patients and widely available IHC HPV assays signifies the routine implementation of p16 testing in day-to-day clinical practice.
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Affiliation(s)
- Sushmita Ghoshal
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Chinna Babu Dracham
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Archana Sundaram
- Department of Pathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rajesh Kumar
- Department of Pathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amanjit Bal
- Department of Pathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashim Das
- Department of Pathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amit Bahl
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Roshan Kumar Verma
- Department of Otorhinolaryngology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Arun Elangovan
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia. Cancers (Basel) 2021; 13:cancers13112691. [PMID: 34070706 PMCID: PMC8198295 DOI: 10.3390/cancers13112691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Among the over 200 human papillomavirus (HPV) genotypes identified, approximately 15 of them can cause human cancers. In this review, we provided an updated overview of the distribution of cancer-causing HPV genotypes by countries in East, Southeast and South Asia. Besides the standard screening and treatment methods employed in these regions, we unravel HPV detection methods and therapeutics utilised in certain countries that differ from other part of the world. The discrepancies may be partly due to health infrastructure, socio-economy and cultural diversities. Additionally, we highlighted the area lack of study, particularly on the oncogenicity of HPV genotype variants of high prevalence in these regions. Abstract Human papillomavirus (HPV) infection remains one of the most prominent cancer-causing DNA viruses, contributing to approximately 5% of human cancers. While association between HPV and cervical cancers has been well-established, evidence on the attribution of head and neck cancers (HNC) to HPV have been increasing in recent years. Among the cancer-causing HPV genotypes, HPV16 and 18 remain the major contributors to cancers across the globe. Nonetheless, the distribution of HPV genotypes in ethnically, geographically, and socio-economically diverse East, Southeast, and South Asia may differ from other parts of the world. In this review, we garner and provide updated insight into various aspects of HPV reported in recent years (2015–2021) in these regions. We included: (i) the HPV genotypes detected in normal cancers of the uterine cervix and head and neck, as well as the distribution of the HPV genotypes by geography and age groups; (ii) the laboratory diagnostic methods and treatment regimens used within these regions; and (iii) the oncogenic properties of HPV prototypes and their variants contributing to carcinogenesis. More importantly, we also unveil the similarities and discrepancies between these aspects, the areas lacking study, and the challenges faced in HPV studies.
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Gupta A, Mathew D, Bhat SA, Ghoshal S, Pal A. Genetic Variants of DNA Repair Genes as Predictors of Radiation-Induced Subcutaneous Fibrosis in Oropharyngeal Carcinoma. Front Oncol 2021; 11:652049. [PMID: 34079756 PMCID: PMC8165303 DOI: 10.3389/fonc.2021.652049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the impact of genetic variants of DNA repair and pro-fibrotic pathway genes on the severity of radiation-induced subcutaneous fibrosis in patients of oropharyngeal carcinoma treated with radical radiotherapy. Materials and Methods Patients of newly diagnosed squamous cell carcinoma of oropharynx being treated with two-dimensional radical radiotherapy were enrolled in the study. Patients who had undergone surgery or were receiving concurrent chemotherapy were excluded. Patients were followed up at 6 weeks post completion of radiotherapy and every 3 months thereafter for a median of 16 months. Subcutaneous fibrosis was graded according to the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) grading system and the maximum grade was recorded over the length of the patient’s follow-up. Patients with severe fibrosis (≥G3), were compared to patients with minor (≤G2) fibrotic reactions. Eight single nucleotide polymorphisms of 7 DNA repair genes and 2 polymorphisms of a single pro-fibrotic pathway gene were analyzed by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism and were correlated with the severity of subcutaneous fibrosis. Results 179 patients were included in the analysis. Subcutaneous fibrosis was seen in 168 (93.9%) patients. 36 (20.1%) patients had severe (grade 3) fibrosis. On multivariate logistic regression analysis, Homozygous CC genotype of XRCC3 (722C>T, rs861539) (p=0.013*, OR 2.350, 95% CI 1.089-5.382), Homozygous AA genotype of ERCC4 Ex8 (1244G>A, rs1800067) (p=0.001**, OR 11.626, 95% CI 2.490-275.901) and Homozygous TT genotype of XRCC5 (1401G>T, rs828907) (p=0.020*, OR 2.188, 95% CI 1.652-7.334) were found to be predictive of severe subcutaneous fibrosis. On haplotype analysis, the cumulative risk of developing severe fibrosis was observed in patients carrying both haplotypes of variant Homozygous AA genotype of ERCC4 Ex8 (1244G>A, rs1800067) and Homozygous TT genotype of XRCC5 (1401 G>T, rs828907) (p=0.010*, OR 26.340, 95% CI 4.014-76.568). Conclusion We demonstrated significant associations between single nucleotide polymorphisms of DNA repair genes and radiation-induced subcutaneous fibrosis in patients of oropharyngeal carcinoma treated with radiotherapy. We propose to incorporate these genetic markers into predictive models for identifying patients genetically predisposed to the development of radiation-induced fibrosis, thus guiding personalized treatment protocols.
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Affiliation(s)
- Ankita Gupta
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Don Mathew
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shabir Ahmad Bhat
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushmita Ghoshal
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnab Pal
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Fagan JJ, Noronha V, Graboyes EM. Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer. Am Soc Clin Oncol Educ Book 2021; 41:1-11. [PMID: 33793315 PMCID: PMC8059263 DOI: 10.1200/edbk_320923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The overwhelming majority of head and neck cancers and related deaths occur in low- and middle-income countries, which have challenges related to burden of disease versus access to care. Yet the additional health care burden of the COVID-19 pandemic has also impacted access to care for patients with head and neck cancer in the United States. This article focuses on challenges and innovation in prioritizing head and neck cancer care in Sub-Saharan Africa, the Indian experience of value-added head and neck cancer care in busy and densely populated regions, and strategies to optimize the management of head and neck cancer in the United States during the COVID-19 pandemic.
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Affiliation(s)
- Johannes J. Fagan
- Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - Evan Michael Graboyes
- Departments of Otolaryngology-Head and Neck Surgery and Public Health Sciences, Medical University of South Carolina, Charleston, SC
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Are Histomorphological Features Predictive of p16 Immunopositivity Different for Oral and Oropharyngeal Squamous Cell Carcinoma? Indian J Surg Oncol 2020; 11:248-255. [PMID: 32523271 DOI: 10.1007/s13193-020-01058-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 03/17/2020] [Indexed: 10/24/2022] Open
Abstract
Evidence from current studies show that squamous cell carcinomas at oral and oropharyngeal sites are distinct and unique, with their own separate etiopathogenesis, treatment, and prognosis. The aim of this work is to correlate p16 immunohistochemical expression with histomorphological features suggestive of HPV infection in oral and oropharyngeal squamous cell carcinoma. A total of 50 consecutive biopsy cases of oral squamous cell carcinoma (OSCC) and 50 consecutive biopsy cases of oropharyngeal squamous cell carcinoma (OPSCC) were evaluated for features suggestive of HPV infection like focal basaloid appearance, nests, and lobules of tumor cells with pushing borders, absence of stromal reaction, central necrosis, focal lymphoepithelial morphology, presence of koilocytes, and non-keratinizing or hybrid morphology. Immunostaining was performed using p16 monoclonal antibody (clone mouse 16P04). Only cases showing a moderate (2+) to high intensity (3+) staining in more than 75% cells were taken as p16 immunopositive. The histological features were correlated with p16 immunopositivity. A total of 18/50 (36%) cases of oral squamous cell carcinoma and 27/50 (54%) cases of oropharyngeal squamous cell carcinoma were p16 immunopositive. On statistical analysis, only nests/lobules with pushing borders were found to have a significant correlation with p16 immunopositivity (P value = 0.0012) for OSCC cases. For OPSCC cases, four histological features namely nests and lobules with pushing borders (P value = 0.0001), focal basaloid appearance (P value = 0.0041), lymphoepithelial morphology (P value = 0.0029), and non-keratinizing/hybrid morphology (P value = 0.0141) had a significant correlation with p16 immunopositivity. Histomorphological features are more helpful in predicting p16 immunopositivity in OPSCC than OSCC.
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Bean MB, Liu Y, Jiang R, Steuer CE, Patel M, McDonald MW, Higgins KA, Beitler JJ, Shin DM, Saba NF. Small Cell and Squamous Cell Carcinomas of the Head and Neck: Comparing Incidence and Survival Trends Based on Surveillance, Epidemiology, and End Results (SEER) Data. Oncologist 2019; 24:1562-1569. [PMID: 31391295 DOI: 10.1634/theoncologist.2018-0054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/06/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Small cell carcinomas of the head and neck (SmCCHNs) are rare neoplasms with an unfavorable prognosis. Population-based data describing survival and prognostic factors for SmCCHN are limited. METHODS Data were obtained from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database for 1973-2013. Patient and tumor-related characteristics for SmCCHN were compared with those for squamous cell carcinoma of the head and neck (SCCHN). Survival was compared by constructing Kaplan-Meier curves and Cox proportional hazard models with and without propensity score matching. RESULTS The data set included 609 SmCCHN and 227,943 SCCHN cases. Both histological subtypes were more common in men than women and more common in white patients. SmCCHN was most likely to originate in the larynx, glottis and hypopharynx, or salivary glands and to present with more advanced stage and grade. SCCHN was most likely to originate in the oral cavity and was found infrequently in the salivary glands. Overall 5- and 10-year survival estimates were 27% and 18% for SmCCHN and 46% and 31% for SCCHN, respectively. In multivariable survival analyses adjusting for age, sex, race, marital status, year of diagnosis, stage, grade, and receipt of radiation, the hazard ratio (HR) comparing SmCCHN with SCCHN was 1.53 with a 95% confidence interval (CI) from 1.39 to 1.68. Average 5-year survival varied widely between the histologic types when comparing tumor sites: 14.5% for SmCCHN versus 48.9% for SCCHN in the oropharynx. In propensity score matched analyses, the corresponding HR was 1.27 (95% CI, 1.15-1.40). CONCLUSION Compared with SCCHN, SmCCHN carries a worse survival and is more likely to present with more advanced stage. IMPLICATIONS FOR PRACTICE Small cell carcinoma of the head and neck (SmCCHN) is a rare subtype of head and neck cancer. In this Surveillance, Epidemiology, and End Results (SEER) data analysis, the characteristics and survival of SmCCHN are compared with those of the common squamous cell carcinoma of the head and neck. Results show that SmCCHN carries a worse prognosis and tends to present at a more advanced stage; SmCCHN also is ten times more likely to originate from the salivary glands. These findings may have implications for clinical practice, as location of the tumor may strongly associate with the pathologic diagnosis. If a SmCCHN is diagnosed, a disseminated disease is likely; hence vigilance in staging procedures is indicated.
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Affiliation(s)
- Marta B Bean
- Emory School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Yuan Liu
- Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Renjain Jiang
- Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Conor Ernst Steuer
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
| | - Mihir Patel
- Department of Otolaryngology, Emory University, Atlanta, Georgia, USA
| | | | | | | | - Dong Moon Shin
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia, USA
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Manoharan V, Karunanayake EH, Tennekoon KH, De Silva S, De Silva K, Angunawela P, Lunec J. Nucleotide variants and protein expression of TP53 in a Sri Lankan cohort of patients with head and neck cancer. Mol Med Rep 2019; 19:2781-2791. [PMID: 30816478 PMCID: PMC6423636 DOI: 10.3892/mmr.2019.9948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/30/2019] [Indexed: 11/20/2022] Open
Abstract
Head and neck cancer (HNC) is the leading cancer in Sri Lankan males and second most common cancer among Sri Lankan females. This is the first study, to the best of our knowledge, that has focused on investigating the association between TP53 somatic DNA variants, with p53 protein expression and risk factors in a cohort of Sri Lankan patients with HNC. A total of 44 patients with cancer and 20 healthy controls were studied. In total, 36 genomic DNA sequence variants were found, including several novel variants (two deletions in exons 4 and 6, two in the 3′ untranslated region and several intronic variants). A total of 14 tumour samples carried pathogenic TP53 mutations. A random selection of 24 samples was analysed immunohistochemically for p53 protein expression. All the samples with point missense variants were strongly immuno-positive, whereas, samples with nonsense and frameshift TP53 variants were immuno-negative for p53 immunohistochemical staining. Although, the human papilloma virus is a known risk factor for HNC, results from the present study identified an absence or lower level of infection in the Sri Lankan cohort.
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Affiliation(s)
- Vahinipriya Manoharan
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 00300, Sri Lanka
| | - Eric Hamilton Karunanayake
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 00300, Sri Lanka
| | - Kamani Hemamala Tennekoon
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 00300, Sri Lanka
| | - Sumadee De Silva
- Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 00300, Sri Lanka
| | - Kanishka De Silva
- Department of Oncosurgery, National Cancer Institute, Maharagama 10280, Sri Lanka
| | - Preethika Angunawela
- Department of Pathology, Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
| | - John Lunec
- Northern Institute for Cancer Research, Newcastle University, Newcastle NE2 4AD, UK
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Prevalence and Impact of Human Papillomavirus on Head and Neck Cancers: Review of Indian Studies. Indian J Surg Oncol 2018; 9:568-575. [PMID: 30538390 DOI: 10.1007/s13193-018-0813-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) is an important emerging etiology for head and neck cancers (HNCs) worldwide. Considering its impact on prognosis, it is important to understand the true prevalence of HPV-associated HNCs in India. This article reviews the prevalence of HPV-related HNCs across various studies in India where the population is predominantly tobacco users, and studies its outcomes with respect to HPV.
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Murthy V, Calcuttawala A, Chadha K, d’Cruz A, Krishnamurthy A, Mallick I, Nair S, Teni T, Pawar S, Talapatra K, Patil A, Bhatt A, Chatterjee S, Swain M, Narayanan P, Ghadyalpatil N, Singhal M, Kuriakose M, Prabhash K, Agarwal J, Parikh P. Human papillomavirus in head and neck cancer in India: Current status and consensus recommendations. South Asian J Cancer 2017; 6:93-98. [PMID: 28975111 PMCID: PMC5615888 DOI: 10.4103/sajc.sajc_96_17] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Human papillomavirus (HPV) associated head and neck squamous cell cancers (HNSCC) have become increasingly common in the West, but the same cannot be said about India. These cancers have a different biology and confer a better prognosis, however, its current role in the management of patients in India is not clearly defined. At the 35th Indian Cooperative Oncology Network conference held in September 2016, a panel of radiation, surgical and medical oncologists, pathologists, and basic scientists from across the country having experience in clinical research with respect to HPV in HNSCC reviewed the available literature from India. All the ideas and facts were thereafter collated in this report. Various topics of controversy in dealing with the diagnosis and management of HPV-associated HNSCC have been highlighted in this report in context to the Indian scenario. Furthermore, the prevalence of the same and its association with tobacco and high-risk sexual behavior has been touched on. Conclusively, a set of recommendations has been proposed by the panel to guide the practicing oncologists of the country while dealing with HPV-associated HNSCC.
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Affiliation(s)
- Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Adnan Calcuttawala
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Kirti Chadha
- Department of Oncopathology, Metropolis Healthcare Ltd., Mumbai, Maharashtra, India
| | - Anil d’Cruz
- Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - Arvind Krishnamurthy
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India
| | - Indranil Mallick
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India
| | - Sudhir Nair
- Department of Head and Neck Surgery, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Tanuja Teni
- Teni Lab, Advanced Centre for Treatment, Research and Education in Cancer, Mumbai, Maharashtra, India
| | - Sagar Pawar
- Teni Lab, Advanced Centre for Treatment, Research and Education in Cancer, Mumbai, Maharashtra, India
| | | | - Asawari Patil
- Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Amit Bhatt
- Department of Medical Oncology, Avinash Cancer Clinic, Pune, Maharashtra, India
| | - Sanjoy Chatterjee
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, West Bengal, India
| | - Monali Swain
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Prasad Narayanan
- Department of Medical Oncology, Cytecare Cancer Hospital, Bengaluru, Karnataka, India
| | - Nikhil Ghadyalpatil
- Department of Medical Oncology, Yashoda Cancer Institute, Somajiguda, Hyderabad, Telangana, India
| | - Manish Singhal
- Department of Medical Oncology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Moni Kuriakose
- Department of Surgical Oncology, Mazumdar-Shaw Cancer Center, Bengaluru, Karnataka, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Jaiprakash Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Purvish Parikh
- Department of Medical Oncology, Asian Institute of Oncology, Mumbai, Maharashtra, India
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