New genetic predictors of prognosis in head and neck cancer

In individual patients with head and neck squamous cell carcinomas (HNSCC), established prognostic factors do not satisfactorily predict clinical outc ome. For the first time we investigated a total of 100 HNSCC by Comparative Genomic Hybridization (CGH) to define chromosomal alterations that are ass ociated with the patients prognosis. Patients were followed for at latest 4 but at least 2 years after surgery or until death. During this observation period twenty-nine of them died because of cancer disease. The Kaplan-Meie r method was used plotting survival curves for every single chromosomal alt eration as well as every clinico-pathological parameter. The curves were te sted for significance by the log rank as well as the Breslow test. Signific ance of particular prognostic parameters was then evaluated by the Cox regr ession model. The overall survival time as well as the recurrence free surv ival time were significantly lower in patients who's tumors showed amplific ations of the chromosomal region 11q13 (p=0.0008 for LR and p=0.0024 for B) . The survival time of the patients was also lower if the carcinomas carrie d overrepresentations of chromosome 3q (p=0.0299 for LR and p=0.0546 for B) . Multivariate analysis (Cox's proportional hazards model) revealed both al terations as most important independent prognostic factors in HNSCC. None o f the conventional clinicopathological parameters (pT-, pN-status, UICC sta ge, grading) achieved statistical significance in the multivariate model. T hese results suggest that in HNSCC the occurence of 11q13 amplification and 3q overrepresentation are highly significant independent prognostic marker s and of better value than the established TNM and grading criteria.