Prognostic significance of Bcl-2 and p53 expression in advanced laryngeal squamous cell carcinoma

Background. Proteins regulating the cell cycle and cell death are frequentl y abnormally expressed in cancer. Several of these, particularly p53 and Bc l-2, have been widely suggested as possible prognostic markers in diverse h uman malignancies. Their role in predicting outcome in squamous cell carcin omas of the head and neck is unclear and may depend on the location, stage, and treatment of the tumor. Methods. To assess this question specifically far advanced squamous cell ca rcinoma of the larynx, we studied 69 patients with stage III or IV tumors, all but 6 of whom were treated with surgery plus postoperative irradiation by a single physician. We studied the patients retrospectively to test the association between expression of Bcl-2 and p53, as assessed by immunohisto chemistry, with treatment outcome and survival. Results. Twenty of the 69 patients died from their tumor (poor outcome); th e rest were alive and tumor free at the last follow-up or died of unrelated causes without clinical tumor recurrence (good outcome). Fourteen tumors h ad detectable Bcl-2 expression, including 8 scored as overexpressors. Thirt y-nine tumors overexpressed p53. Expression of neither Bcl-2 nor p53 was as sociated with outcome, overall survival, or disease-free survival. Only tum or stage was significantly associated with outcome and disease-free surviva l. Conclusion. These data indicate that assessing expression of p53 or Bcl-2 i s unlikely to be prognostically useful for surgically treated advanced lary ngeal carcinoma. (C) 2001 John Wiley & Sons, Inc.