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Erschienen in:
01.10.2014 | Original article
Evaluation of the prognostic role of tumor cell podoplanin expression in locally advanced squamous cell carcinoma of the head and neck
Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2014
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Background and purpose
To investigate the potential prognostic role of tumor cell podoplanin expression in patients treated with resection followed by irradiation or chemoradiotherapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN).
Materials and methods
Podoplanin expression (≤10 % versus > 10 %) and 12 other factors were evaluated in 160 patients for their association with locoregional control (LRC), metastases-free (MFS) and overall survival (OS). Other factors were age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, preradiotherapy (pre-RT) hemoglobin level, tumor site, histological grading, T category, N category, American Joint Committee on Cancer (AJCC) stage, human papillomavirus (HPV) status, extent of resection and concurrent chemotherapy.
Results
In multivariate analysis, ECOG performance status 0–1 (risk ratio, RR: 3.01; 95 % confidence interval, CI: 1.42–7.14; p = 0.003), pre-RT hemoglobin levels ≥ 7.45 mmol/l (12 g/dl; RR: 2.03; 95 % CI: 1.04–3.94; p = 0.038), oropharyngeal cancer (RR: 1.25; 95 % CI: 1.01–1.55; p = 0.038) and T category T1–2 (RR: 1.81; 95 % CI: 1.24–2.79; p = 0.002) were significantly associated with improved LRC. T category T1–2 (RR: 1.90; 95 % CI: 1.25–3.06; p = 0.002) and N category N0–2a (RR: 5.22; 95 % CI: 1.96–18.09; p < 0.001) were significantly associated with better MFS. Pre-RT hemoglobin levels ≥ 7.45 mmol/l (RR: 2.44; 95 % CI: 1.27–4.74; p = 0.007), T category T1–2 (RR: 1.97; 95 % CI: 1.36–3.04; p < 0.001) and N category N0–2a (RR: 2.87; 95 % CI: 1.37–6.61; p = 0.005) were significantly associated with improved OS. Podoplanin expression ≤ 10 % showed a trend towards improved OS on both univariate (p = 0.050) and multivariate analysis (RR: 1.86; 95 % CI: 0.96–3.59; p = 0.07).
Conclusion
Treatment outcomes were significantly associated with performance status, pre-RT hemoglobin level, tumor site and tumor stage. Tumor cell expression of podoplanin ≤ 10 % showed a trend towards improved OS when compared to podoplanin expression of > 10 %.