Indications for postoperative radiotherapy in laryngeal carcinoma: a panel of tumor tissue markers for predicting locoregional recurrence in surgically treated carcinoma. A pilot study

Head Neck. 2014 Nov;36(11):1534-40. doi: 10.1002/hed.23493. Epub 2013 Dec 18.

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.

Keywords: CD105; angiogenin; laryngeal carcinoma; mammary serine protease inhibitor (MASPIN); markers panel; nm23-H1; postoperative radiotherapy (RT).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Biomarkers, Tumor / blood*
  • Carcinoma, Squamous Cell / blood
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / blood
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Immunohistochemistry
  • Laryngeal Neoplasms / blood
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / methods
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • NM23 Nucleoside Diphosphate Kinases / blood
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Pilot Projects
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Radiotherapy, Adjuvant
  • Ribonuclease, Pancreatic / blood
  • Sensitivity and Specificity
  • Serpins / blood
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • NM23 Nucleoside Diphosphate Kinases
  • SERPIN-B5
  • Serpins
  • NME1 protein, human
  • angiogenin
  • Ribonuclease, Pancreatic