Clinical Profile and Survival of Oropharyngeal Squamous-Cell Carcinoma in a Region of Northern Spain with a Low HPV-Attributable Fraction: A Retrospective Cohort Study
4 affiliations
- 1Department of Otorhinolaryngology—Head and Neck Surgery, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain
- 2Department of Medical Oncology, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain
- 3Department of Radiation Oncology, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain
- 4Department of Pathology, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain
Abstract
Background/Objectives: p16 immunohistochemistry is the standard surrogate for HPV causation in oropharyngeal squamous-cell carcinoma (OPSCC), but p16/HPV discordance is more frequent where the HPV-attributable fraction is low. We assessed the p16-positive fraction, p16/HPV-DNA discordance, and survival of OPSCC in northern Spain. Methods: Retrospective cohort of 152 consecutive OPSCC (2019–2024). HPV-DNA PCR was performed selectively in p16-positive tumours; selection was assessed with a quantitative bias analysis. Overall survival (OS) was analysed with Kaplan–Meier and Cox regression. Results: Fifty-seven tumours (37.5%) were p16-positive; these patients were younger, drank less often, and more often had tonsil/base-of-tongue primaries. HPV-DNA was negative in six of twenty-eight tested p16-positive tumours (discordance 21.4%; 95% CI 10.2–39.5). Testing favoured never-drinkers, and sensitivity analyses for selective testing gave estimates of 16–36%. Two-year OS was 86.3% for p16-positive and 53.9% for p16-negative disease. p16 negativity was associated with death after adjustment for stage, alcohol, and age (HR 3.00; 95% CI 1.44–6.26), but the association was attenuated in curatively treated patients (HR 2.30; 95% CI 0.99–5.33). Conclusions: In this region, about one in three OPSCC is p16-positive and one in five tested p16-positive tumours lacks HPV-DNA. Systematic dual p16/HPV testing is advisable before p16 status guides staging or de-escalation.
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BibTeX
@article{chiesaestomba2026clinical,
title = {{Clinical Profile and Survival of Oropharyngeal Squamous-Cell Carcinoma in a Region of Northern Spain with a Low HPV-Attributable Fraction: A Retrospective Cohort Study}},
author = {Carlos M. Chiesa-Estomba and Maider Andueza-Guembre and Paulina Droppelman-Álvarez and Laura Basterretxea-Badiola and Leyre González-Vallejo and Pablo Aguirre-Echeverria and Ekhiñe Larruscain-Sarasola and José Ángel González-García and Jon Alexander Sistiaga-Suárez},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18213433},
url = {https://www.mdpi.com/2072-6694/18/21/3433},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical Profile and Survival of Oropharyngeal Squamous-Cell Carcinoma in a Region of Northern Spain with a Low HPV-Attributable Fraction: A Retrospective Cohort Study
AU - Carlos M. Chiesa-Estomba
AU - Maider Andueza-Guembre
AU - Paulina Droppelman-Álvarez
AU - Laura Basterretxea-Badiola
AU - Leyre González-Vallejo
AU - Pablo Aguirre-Echeverria
AU - Ekhiñe Larruscain-Sarasola
AU - José Ángel González-García
AU - Jon Alexander Sistiaga-Suárez
PY - 2026
DA - 2026/10/23
JO - Cancers
DO - 10.3390/cancers18213433
UR - https://www.mdpi.com/2072-6694/18/21/3433
AB - Background/Objectives: p16 immunohistochemistry is the standard surrogate for HPV causation in oropharyngeal squamous-cell carcinoma (OPSCC), but p16/HPV discordance is more frequent where the HPV-attributable fraction is low. We assessed the p16-positive fraction, p16/HPV-DNA discordance, and survival of OPSCC in northern Spain. Methods: Retrospective cohort of 152 consecutive OPSCC (2019–2024). HPV-DNA PCR was performed selectively in p16-positive tumours; selection was assessed with a quantitative bias analysis. Overall survival (OS) was analysed with Kaplan–Meier and Cox regression. Results: Fifty-seven tumours (37.5%) were p16-positive; these patients were younger, drank less often, and more often had tonsil/base-of-tongue primaries. HPV-DNA was negative in six of twenty-eight tested p16-positive tumours (discordance 21.4%; 95% CI 10.2–39.5). Testing favoured never-drinkers, and sensitivity analyses for selective testing gave estimates of 16–36%. Two-year OS was 86.3% for p16-positive and 53.9% for p16-negative disease. p16 negativity was associated with death after adjustment for stage, alcohol, and age (HR 3.00; 95% CI 1.44–6.26), but the association was attenuated in curatively treated patients (HR 2.30; 95% CI 0.99–5.33). Conclusions: In this region, about one in three OPSCC is p16-positive and one in five tested p16-positive tumours lacks HPV-DNA. Systematic dual p16/HPV testing is advisable before p16 status guides staging or de-escalation.
SN - 2072-6694
ER -