Correlation of clinicopathological parameters and biological markers related to apoptosis and proliferative activity with a clinical outcome in squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy

Objective: This study was designed to determine whether biological markers related to apoptosis or proliferative activity are associated with the clin ical outcome in patients with squamous cell carcinoma (SCC) of the larynx t reated with concurrent chemoradiotherapy. Methods: Immunostaining with anti bodies specific to p53, bcl-2, bar, and MIB-1 was performed to evaluate exp ression of these proteins in formalin-fixed, paraffin-embedded specimens of 59 patients treated with concurrent chemoradiotherapy (carboplatin, 100 mg /m(2), four to six times every week; total radiation dose of 40-65 Gy over 4-6.5 weeks). Results: Multivariate analysis indicated that nodal status wa s a significant indicator of overall survival (OS; P = 0.001). Patients wit h bcl-2 positive tumors had better OS than those with bcl-2 negative tumors in both univariate (P = 0.002) and multivariate analyses (P < 0.001). In t he univariate analysis, a considerable difference in OS was observed among the expressions of bar (P = 0.077), MIB-I proteins (P = 0.071), and OS, but the difference was not statistically significant. Conclusion: This study i ndicates that nodal status is the major prognostic factor in patients with SCC of the larynx treated with concurrent chemoradiotherapy. These results provide useful information for predicting prognosis. Further analysis of bi ological factors is needed to evaluate the value as predictive markers. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.