Abstract
Background: Head and neck squamous cell carcinoma (HNSCC) represents a common cancer worldwide. Past therapeutic advances have not significantly improved HNSCC prognosis. Therefore, it is necessary to further stratify HNSCC, especially with recent advances in tumor immunology.Methods: Tissue microarrays were assembled from tumor tissue samples and were complemented with comprehensive clinicopathological data of n = 419 patients. H&E whole slides from resection specimen (n = 289) were categorized according to their immune cell infiltrate as “hot,” “cold,” or “excluded.”Results: Investigating tumor immune cell patterns, we found significant differences in survival rates. Immunologic “hot” and “excluded” HNSCCs are associated with better overall survival than “cold” HNSCC patients (p < 0.05). Interestingly, the percentage of all three patterns is nearly identical in p16 positive and negative HNSCCs.Conclusions: Using a plain histological H&E approach to categorize HNSCC as being immunologic “hot,” “cold,” or “excluded” can offer a forecast of patients' prognosis and may thus aid as a potential prognostic tool in routine pathology reports. This “hot-cold-excluded” scheme needs to be applied to more HNSCC cohorts and possibly to other cancer types to determine prognostic meaning, e.g., regarding OS or DFS. Furthermore, our cohort reflects epidemiological data in the national, European, and international context. It may, therefore, be of use for future HNSCC characterization.
Highlights
Head and neck squamous cell carcinoma (HNSCC) are the 6th most common cancer in humans [1, 2]
We established a cohort of 419 HNSCC patients (22.5% female, 77.5% male) with 27.7% being p16 positive
The majority of HNSCC primary tumors (PT) were located in the oropharynx, larynx and oral cavity, followed by hypopharynx (Table 1)
Summary
HNSCCs are the 6th most common cancer in humans [1, 2]. Patients may suffer from visible defacements, scars, and functional impairments like dysphagia or permanent voice changes. Patients tend to suffer from dysphagia by xerostomia and necrosis, atrophy and fibrosis of the bone and the different parts of soft tissue [3]. Given these therapy-induced impairments, the prognosis is still rather poor. With an increasing tumor stage, there is a decreasing survival. Head and neck squamous cell carcinoma (HNSCC) represents a common cancer worldwide. Past therapeutic advances have not significantly improved HNSCC prognosis. It is necessary to further stratify HNSCC, especially with recent advances in tumor immunology
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