BIOLOGICAL INDICATORS OF SURVIVAL IN PATIENTS TREATED BY SURGERY FOR SQUAMOUS-CELL CARCINOMA OF THE ORAL CAVITY AND OROPHARYNX

Squamous cell carcinomas of the head and neck are a heterogeneous grou p of tumours with regard to anatomical site, natural history and respo nse to various treatments. Assessment of the role of biomarkers as ind icators of prognosis or response to treatment is thus complex. In the last decade, different biomarkers have been investigated in the search for objective and reproducible indicators of prognosis. In 69 squamou s cell carcinomas of the oral cavity or oropharynx from patients treat ed with radical surgery alone, we determined cell kinetics, evaluated as in vitro H-3-thymidine labelling index (TLI), p53, bcl-2 and glutat hione S-transferase pi (GST pi) expression, by using immunohistochemic al methods. The biological variables were unrelated to one another or to established clinical and pathological prognostic factors. Univariat e analysis showed that a low proliferative activity was associated to a significantly higher risk of death than that observed in patients wi th a high TLI, whereas p53, bcl-2 and GST pi expression did not provid e prognostic information. Multivariate analysis showed that cell proli feration, gender and nodal status retained their clinical relevance. I n the subset of node-negative patients, TLI and p53 expression were in dicators of survival. Moreover, the combined analysis of TLI and p53 e xpression identified a subgroup of node-negative patients with slowly proliferating and highly p53-expressing tumours who died within 1 year of radical surgery. These results indicate that in patients with oper able oral cavity and oropharyngeal cancer, biomarkers can provide impo rtant information on clinical outcome. (C) 1997 Elsevier Science Ltd. All rights reserved.