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European Archives of Oto-Rhino-Laryngology

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01-11-2015 | Head and Neck

Elderly patients at higher risk of laryngeal carcinoma recurrence could be identified by a panel of two biomarkers (nm23-H1 and CD105) and pN+ status

Authors: Andrea Lovato, Gino Marioni, Enzo Manzato, Claudia Staffieri, Luciano Giacomelli, Giovanni Ralli, Alberto Staffieri, Stella Blandamura

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2015

Abstract

Laryngeal squamous cell carcinoma (LSCC) recurrences are very difficult to manage in elderly patients (age ≥65 years), because treatment carries significant morbidity and mortality. The aim of this study was to develop a panel of parameters (clinicopathological variables or biomarkers) to improve our ability to detect elderly patients at higher risk of LSCC recurrence. Maspin, nm23-H1, and CD105 were investigated using immunohistochemistry on surgical specimens from 46 elderly patients treated for LSCC. After univariate analysis identified parameters associated with LSCC recurrence, a multivariate prognostic model was constructed. At univariate analysis, a higher recurrence rate was significantly associated with nm23-H1 nuclear expression in carcinoma cells ≤2.0 % (p = 0.01), CD105 expression in intratumoral vascular endothelial cells ≥5.28 % (p = 0.04), and pN+ status (p = 0.04). Multivariate modeling confirmed that nuclear nm23-H1 ≤2.0 % (p = 0.009) and CD105 ≥5.28 % (p = 0.013) had a negative prognostic significance in terms of disease recurrence, while pN+ status showed a trend toward significance (p = 0.05). We thus obtained a panel comprising two biomarkers and neck lymph node status that revealed an excellent discriminatory power [AUC (ROC) of 0.81] in terms of the risk of LSCC recurrence. The panel achieved a specificity of 96 % and a positive predictive value of 93 %. We identified a panel with an excellent discriminatory power in identifying elderly patients at higher risk of recurrence after treatment for LSCC. These patients would benefit from a more aggressive primary treatment.

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Title: Elderly patients at higher risk of laryngeal carcinoma recurrence could be identified by a panel of two biomarkers (nm23-H1 and CD105) and pN+ status
Authors: Andrea Lovato
Gino Marioni
Enzo Manzato
Claudia Staffieri
Luciano Giacomelli
Giovanni Ralli
Alberto Staffieri
Stella Blandamura
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2015
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-014-3310-1

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Elderly patients at higher risk of laryngeal carcinoma recurrence could be identified by a panel of two biomarkers (nm23-H1 and CD105) and pN+ status

Abstract

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Abstract

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