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Prognostic value of hypoxia‐associated markers in advanced larynx and hypopharynx squamous cell carcinoma
Author(s) -
Bernstein Jonathan M.,
Andrews Timothy D.,
Slevin Nick J.,
West Catharine M. L.,
Homer Jarrod J.
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24933
Subject(s) - medicine , larynx , immunohistochemistry , hazard ratio , oncology , hypoxia (environmental) , pathology , gastroenterology , surgery , confidence interval , chemistry , organic chemistry , oxygen
Objectives/Hypothesis To determine the prognostic value of hypoxia‐associated markers carbonic anhydrase‐9 (CA‐9) and hypoxia‐inducible factor‐1α (HIF‐1α) in advanced larynx and hypopharynx squamous cell carcinoma (SCCa) treated by organ preservation strategies. Study Design Retrospective cohort study. Methods Pretreatment CA‐9 and HIF‐1α expression, clinicopathologic data, and tumor volume were analyzed in a series of 114 patients with T3–4 SCCa larynx or hypopharynx treated by (chemo)radiation. Results Adverse prognostic factors for locoregional control were T4 classification ( P = 0.008), and for disease‐specific survival were CA‐9 positivity ( P = 0.039), T4 classification ( P = 0.001), larger tumor volume ( P = 0.004), N1–3 classification ( P = 0.002), and pretreatment hemoglobin < 13.0 g/dl ( P = 0.014). With increasing CA‐9 expression, there was a trend to increasing tumor recurrence (P trend = 0.009) and decreasing survival (P trend = 0.002). On multivariate analysis, independent variables were T4 classification (hazard ratio [HR] 13.54, P = 0.01) for locoregional failure, and CA‐9 positivity (HR = 8.02, P = 0.042) and higher tumor volume (HR = 3.33, P = 0.007) for disease‐specific mortality. Conclusion This is the first study to look specifically at T3 and T4 SCCa larynx and hypopharynx for a relationship between hypoxia‐associated marker expression and clinical outcome. Pretreatment immunohistochemical CA‐9 expression is an adverse prognostic factor for disease‐specific survival, indicating that CA‐9 expression may confer a more aggressive tumor phenotype. Level of Evidence 4. Laryngoscope , 125:E8–E15, 2015