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Arch Otolaryngol Head Neck Surg. 2008 Jul;134(7):743-9. doi: 10.1001/archotol.134.7.743.

Biological markers and prognosis in recurrent oral cancer after salvage surgery.

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  • 1Department of Head and Neck Surgery-Otorhinolaryngology, Hospital A. C. Camargo, Rua Professor Antonio Prudente, 211, 01509-900 São Paulo, Brazil.

Abstract

OBJECTIVE:

To analyze the prognostic effect of epidermal growth factor receptor (EGFR), matrix metalloproteinases 2 and 9, and vascular endothelial growth factor expression in patients with locally recurrent oral carcinoma after salvage surgery.

DESIGN:

Retrospective cohort study. Settings Tertiary center cancer hospital.

PATIENTS:

The charts of 111 patients with local recurrence of oral carcinomas were retrospectively analyzed. The previous treatment consisted of surgery in 33 patients (30.0%), radiotherapy with or without chemotherapy in 46 patients (41.0%), and surgery with adjuvant radiotherapy in 32 patients (29.0%). The expression of EGFR, matrix metalloproteinases 2 and 9, and vascular endothelial growth factor was analyzed with a tissue microarray immunohistochemical technique.

MAIN OUTCOME MEASURES:

Overall survival and cancer-specific survival (CSS).

RESULTS:

The recurrences were diagnosed in less than 1 year in 69 patients (62.2%) and in more than 1 year in 42 patients (37.8%). The prognosis was worse in the group with the disease-free interval of less than 1 year (P = .01). Patients with more advanced disease (clinical stage of recurrence, III/IV) had worse rates of CSS (P = .04). Cases that were positive for EGFR had a 3-year CSS of 27.2%, while EGFR-negative cases had a 3-year CSS of 64.3% (P = .001). The expression of matrix metalloproteinases 2 (P = .83) and 9 (P = .15) and vascular endothelial growth factor (P = .86) was not significant in this group. In multivariate analysis, only the disease-free interval and the overexpression of EGFR were associated with a higher risk of cancer death.

CONCLUSIONS:

Local recurrence in oral carcinomas carries a poor prognosis. A disease-free interval of more than 1 year and a EGFR-negative expression are the main prognostic factors related to better CSS in patients treated with salvage surgery.

PMID:
18645125
DOI:
10.1001/archotol.134.7.743
[PubMed - indexed for MEDLINE]
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