Indications for postoperative radiotherapy in laryngeal carcinoma: A panel of tumor tissue markers for predicting locoregional recurrence in surgically treated carcinoma. A pilot study
A preliminary version of this study won the first prize of the Gradenigo–Ferreri–Bilancioni Annual National Award of the Italian Otolaryngological Society (SIO) Rome, May 2013.
Abstract
Background
Combining primary surgery with postoperative radiotherapy (RT) significantly reduces locoregional recurrence rates in selected patients with laryngeal squamous cell carcinoma (SCC). A prognostic model was used to see if associating laryngeal SCC tissue markers (mammary serine protease inhibitor [MASPIN], CD105, angiogenin [ANG], and nm23-H1) with conventional criteria could better discriminate higher-risk patients warranting postoperative RT.
Methods
The study involved 76 consecutively operated patients with laryngeal SCC not recommended for postoperative RT, in accord with current guidelines.
Results
On multivariate statistical modeling, non-nuclear MASPIN expression (p = .022), a CD105 expression ≥5.28% in vascular endothelial cells (p = .003), an nm23-H1 nuclear expression in carcinoma cells ≤12.0% (p = .028), and an ANG expression ≥5.0% (p = .07, statistical trend) showed a negative prognostic significance. The discriminatory power for disease recurrence of the 4 considered biomarkers generated an area under the curve (AUC; receiver operating characteristic [ROC]) of 0.872. The Hosmer–Lemeshow scale indicated an excellent discriminatory power.
Conclusion
This panel's ability to predict laryngeal SCC recurrence warrants further prospective, randomized studies to assess its use among the parameters routinely considered before recommending postoperative RT for patients with laryngeal SCC. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1534–1540, 2014
