Predictive markers for response to chemotherapy, organ preservation, and survival in patients with advanced laryngeal carcinoma

OBJECTIVE: A systematic retrospective study of the largest randomized trial of induction chemotherapy and radiation for advanced laryngeal cancer was undertaken to determine whether specific tumor or biologic factors were pre dictive of chemotherapy response, organ preservation, or survival. METHODS: The variables analyzed included clinical and histologic factors, i mmunohistochemical expression of proliferating cell nuclear antigen and p53 , and adjusted DNA index measurements, Variables were evaluated for correla tion with outcomes of tumor response, organ preservation, and survival. RESULTS: Multivariate analysis revealed that the best predictor of complete response to induction chemotherapy was low T class. The full multivariate model for predicting larynx preservation in patients treated with induction chemotherapy plus radiation shows that T class, p53 overexpression, and el evated proliferating cell nuclear antigen index were independent predictors of successful organ preservation. CONCLUSION: These predictive markers should be included in future clinical trials of advanced laryngeal cancer to determine their usefulness prospecti vely.