IS P53 AN INDEPENDENT PROGNOSTIC FACTOR IN PATIENTS WITH LARYNGEAL CARCINOMA

BACKGROUND. Carcinoma of the true vocal cord represents the earliest c linically recognizable invasive malignancy in the head and neck region and provides a unique model for studying possible prognostic genetic markers. The aim of this study was to determine whether p53 overexpres sion correlated with tumor recurrence in a homogenous population of pa tients with early stage glottic carcinoma treated with radiotherapy al one. METHODS. One hundred and fourteen patients with T1N0M0 squamous c ell carcinoma of the glottis were treated with curative radiotherapy b etween 1976 and 1990. With a median follow-up of 6 years, actuarial lo cal control was 80% with 23 local recurrences. Laryngeal biopsy specim ens obtained prior to radiation therapy were analyzed retrospectively in 22 patients. Forty-five patients with local control were used as a control group. p53 overexpression indicating a mutated p53 gene was an alyzed by immunohistochemistry using the mouse monoclonal antibody D0- 7. RESULTS. Approximately 82% of carcinomas that recurred locally expr essed p53 compared with only 29% of those with local control (P < 0.00 1). No significant relation was noted between p53 expression and histo logic grade. Intensity of staining did not predict tumor recurrence. C ONCLUSIONS. The authors believe that this case-controlled study demons trated the role of p53 as an independent prognostic factor in patients with early stage glottic carcinoma. (C) 1998 American Cancer Society.