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Strahlentherapie und Onkologie

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01-10-2013 | Original article

Androgen receptor expression

Prognostic value in locally advanced squamous cell carcinoma of the head and neck

Authors: D. Rades, M.D., N.D. Seibold, S.E. Schild, M.P. Gebhard, F. Noack

Published in: Strahlentherapie und Onkologie | Issue 10/2013

Abstract

Background and purpose

This study investigated the prognostic value of androgen receptor (AR) expression of tumor cells in patients treated with surgery and subsequent radio(chemo)therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN).

Material and methods

The impact of AR and 11 additional factors on locoregional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively studied in 163 patients with nonmetastatic stage III/IV SCCHN. Additional factors included age, gender, ECOG performance status, pre-radiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T category, N category, HPV status, extent of resection, and concurrent chemotherapy.

Results

On multivariate analysis, improved LRC was significantly associated with pre-RT hemoglobin levels ≥ 12 g/dl (risk ratio [RR] 2.22; 95 % confidence interval [CI] 1.19–4.13; p = 0.013), tumor site (RR 1.39; 95 % CI 1.14–1.70; p = 0.001), lower T category (RR 1.67; 95 % CI 1.18–2.44; p = 0.003), and lower N category (RR 4.18; 95 % CI 1.90–10.55; p < 0.001). Improved MFS was associated with AR expression (RR 2.21; 95 % CI 1.01–5.41; p = 0.048), better ECOG performance status (RR 3.19; 95 % CI 1.50–7.14; p = 0.003), lower T category (RR 2.24; 95 % CI 1.47–3.65; p < 0.001), and lower N category (RR 5.33; 95 % CI 2.07–16.63; p < 0.001). OS was positively associated with AR expression (RR 1.99; 95 % CI 1.06–4.00; p = 0.032), better ECOG performance status (RR 2.20; 95 % CI 1.20–4.09; p = 0.010), pre-RT hemoglobin levels ≥ 12 g/dl (RR 2.13; 95 % CI 1.19–3.82; p = 0.012), lower T category (RR 1.81; 95 % CI 1.30–2.62; p < 0.001), and lower N category (RR 3.41; 95 % CI: 1.65–7.80; p < 0.001).

Conclusion

Tumor cell expression of AR was an independent prognostic factor for MFS and OS and should be considered in future prospective trials.

Becker A, Stadler P, Lavey RS et al (2000) Severe anemia is associated with poor tumor oxygenation in head and neck squamous cell carcinomas. Int J Radiat Oncol Biol Phys 46:459–466PubMedCrossRef

Cerezo L, Millan I, Torre A et al (1992) Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer. A multivariate study of 492 cases. Cancer 69:1224–1234PubMedCrossRef

Colella G, Izzo G, Campisi G et al (2011) Expression of sexual hormones receptors in oral squamous cell carcinoma. Int J Immunopathol Pharmacol 24(2 Suppl):129–132PubMed

Denis F, Garaud P, Bardet E et al (2004) Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol 22:69–76PubMedCrossRef

Gan L, He J, Zhang X et al (2012) Expression profile and prognostic role of sex hormone receptors in gastric cancer. BMC Cancer 12:566PubMedCrossRef

Gonzalez LO, Corte MD, Vazquez J et al (2008) Androgen receptor expression in breast cancer: relationship with clinicopathological characteristics of the tumors, prognosis, and expression of metalloproteases and their inhibitors. BMC Cancer 8:149PubMedCrossRef

Jeremic B, Milicic B (2009) Pretreatment prognostic factors of survival in patients with locally advanced nonmetastatic squamous cell carcinoma of the head and neck treated with radiation therapy with or without concurrent chemotherapy. Am J Clin Oncol 32:163–168PubMedCrossRef

Jeremic B, Milicic B (2008) Pretreatment prognostic factors of local recurrence-free survival in locally advanced squamous cell carcinoma of the head and neck treated with radiation therapy with or without concurrent chemotherapy. Am J Clin Oncol 31:213–218PubMedCrossRef

Kauffman EC, Robinson BD, Downes MJ et al (2011) Role of androgen receptor and associated lysine-demethylase coregulators, LSD1 and JMJD2A, in localized and advanced human bladder cancer. Mol Carcinog 50:931–944PubMedCrossRef

10.

Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef

11.

Li R, Wheler T, Dai H et al (2004) High level of androgen receptor is associated with aggressive clinicopathologic features and decreased biochemical recurrence-free survival in prostate cancer patients treated with radical prostatectomy. Am J Surg Pathol 28:928–934PubMedCrossRef

12.

Magri F, Capelli V, Rotondi M et al (2012) Expression of estrogen and androgen receptors in differentiated thyroid cancer: an additional criterion to assess the patient’s risk. Endocr Relat Cancer 19:463–471PubMedCrossRef

13.

Peters AA, Buchanan G, Ricciardelli C et al (2009) Androgen receptor inhibits estrogen receptor-alpha activity and is prognostic in breast cancer. Cancer Res 69:6131–6140PubMedCrossRef

14.

Petersen I, Schewe C, Schlüns K et al (2007) Inter-laboratory validation of PCR-based HPV detection in pathology specimens. Virchows Arch 451:701–716PubMedCrossRef

15.

Thibaudeau E, Fortin B, Coutlee F et al (2013) HPV prevalence and prognostic value in a prospective cohort of 255 patients with locally advanced HNSCC: a single-centr experience. Int J Otolaryngol 2013:437815PubMed

16.

Rades D, Setter C, Dahl O et al (2012) The prognostic impact of tumor cell expression of estrogen receptor alpha, progesterone receptor and androgen receptor in patients irradiated for nonsmall cell lung cancer. Cancer 118:157–163PubMedCrossRef

17.

Rades D, Stoehr M, Kazic N et al (2008) Locally advanced stage IV squamous cell carcinoma of the head and neck: impact of pre-radiotherapy hemoglobin level and interruptions during radiotherapy. Int J Radiat Oncol Biol Phys 70:1108–1114PubMedCrossRef

18.

Wentzensen N, Knebel-Doeberitz M (2004) Viral cancerogenesis of head and neck tumors. Pathologe 25:21–30PubMedCrossRef

19.

Wikström P, Marusic J, Stattin P, Bergh A (2009) Low stroma androgen receptor level in normal and tumor prostate tissue is related to poor outcome in prostate cancer patients. Prostate 69:799–809PubMedCrossRef

20.

Yu Q, Niu Y, Zhang JZ et al (2011) Expression of androgen receptor in breast cancer and its significance as a prognostic factor. Ann Oncol 22:1288–1294PubMedCrossRef

Title: Androgen receptor expression
Prognostic value in locally advanced squamous cell carcinoma of the head and neck
Authors: D. Rades, M.D.
N.D. Seibold
S.E. Schild
M.P. Gebhard
F. Noack
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 10/2013
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-013-0389-z

At a glance: The STEP trials

Springer Medicine

Androgen receptor expression

Prognostic value in locally advanced squamous cell carcinoma of the head and neck

Abstract

Background and purpose

Material and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background and purpose

Material and methods

Results

Conclusion

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