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Salas et al. J Cancer Metastasis Treat 2018;4:15 Journal of Cancer
DOI: 10.20517/2394-4722.2017.66 Metastasis and Treatment

Original Article Open Access

Nodal involvement and p16-staining in upper
alveolar ridge and hard palate cancer

Edgar Salas , Pedro Sanchez , Juan Postigo , Carlos A. Castaneda , Miluska Castillo , Valeria Villegas ,
2
2,3
1
1
2
1
Luis Cano , Sandro Casavilca , Luis A. Bernabe , Carolina Belmar , Maria R. Villa-Robles , Raul Mantilla ,
4
2
4
2
2
2
Henry Guerra 4
1 Head & Neck Surgery Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
2 Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
3 Faculty of Medicine, Universidad Peruana San Juan Bautista, Lima 15067, Peru.
4 Pathology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima 15038, Peru.
Correspondence to: Dr. Carlos A. Castaneda, Medical Oncology Department and Research Department, Instituto Nacional de
Enfermedades Neoplasicas, Av. Angamos Este 2520 Surquillo, Lima 15038, Peru. E-mail: carloscastanedaaltamirano@yahoo.com
How to cite this article: Salas E, Sanchez P, Postigo J, Castaneda CA, Castillo M, Villegas V, Cano L, Casavilca S, Bernabe LA, Belmar
C, Villa-Robles MR, Mantilla R, Guerra H. Nodal involvement and p16-staining in upper alveolar ridge and hard palate cancer. J Cancer
Metastasis Treat 2018;4:15. http://dx.doi.org/10.20517/2394-4722.2017.66
Received: 21 Nov 2017 First Decision: 8 Jan 2018 Revised: 10 Jan 2018 Accepted: 29 Jan 2018 Published: 28 Mar 2018
Science Editor: Masayuki Watanabe Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Aim: Upper alveolar ridge and hard palate squamous cancer is an infrequent malignancy. We evaluated factors associated
with neck involvement and with p16-staining.

Methods: Head and neck squamous-cell carcinoma (SCC) patients who went to Head and Neck Department between
1997 and 2011 were screened, and 73 resected upper alveolar ridge and 5 hard palate SCC were selected. Tumors with
available tissue were stained with p16 immunohistochemistry.

Results: Median age was 64.4 years, 55.1% were female, and 73.1% were in clinical stage IV. Neck dissections were
performed in 24 and pathologically confirmed node metastases were found in 19 (24.3%). Cervical recurrence was found
in 18 patients (23.1%) and was associated with histological grade (P = 0.037). Three (7.3%) of 41 lesions were positive
for p16 and tended to be younger (P = 0.067). Lymphovascular invasion was associated with shorter disease-free survival
(DFS) (P = 0.026) and overall survival (OS) (P = 0.021). Larger cT (P = 0.019), perineural invasion (P = 0.039) and
neck dissection (P = 0.010) were associated with shorter OS. Neck node involvement tended to have shorter DFS (31%
vs. 48.7%, P = 0.278) and OS (25.1% vs. 48.5%, P = 0.340), and neck recurrence tended to have shorter OS (9.3% vs.
52.3%, P = 0.064).

Conclusion: Neck involvement and recurrence are frequent in this location. P16-positive cases were present in 7.3% and
tended to be associated with younger age.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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