P53 EXPRESSION IN END-STAGE SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK PRIOR TO CHEMOTHERAPY TREATMENT - EXPRESSION CORRELATES WITH A VERY POOR CLINICAL OUTCOME

p53 expression was assessed immunohistochemically in 24 'end stage dis ease' patients with squamous cell carcinoma of the head and neck, prio r to selection for a chemotherapy trial. Twelve patients were assigned to each arm of the trial; cisplatinum arm or the cisplatinum and nife dipine arm. p53 expression was assessed using the CM-1 antibody in spe cimens from biopsies or surgically removed tissue at the time these pa tients were assessed as end stage disease. Sixty-six per cent had p53 positive nuclear staining but no correlation was found between p53 sta ining and age, sex, site of primary tumour, tumour stage, or site of t he recurrence. Three patients responded to cisplatinum chemotherapy tr eatment, two of whom had p53 positive staining. p53 survival curves we re calculated for these patients from the date they were assessed as ' end stage disease', p53 overexpression was found to correlate with a v ery poor clinical outcome (P<0.05). Survival curves for 109 head and n eck patients calculated from the date the disease first presented show ed no correlation with p53 expression.