Molecular marker expression in oral and oropharyngeal squamous cell carcinoma

Objective: To determine the relative prognostic value of p53, cyclin D1, ep idermal growth factor receptor (EGFR), and vascular endothelial growth fact or (VEGF) expression in patients with oral and oropharyngeal squamous cell carcinoma. Design: Retrospective cohort study. Patients: Fifty-six patients with oral and oropharyngeal squamous cell carc inoma referred to the Department of Therapeutic Radiology at Yale-New Haven Hospital (Conn) between 1981 and 1992 who were treated with gross total su rgical resection and postoperative external beam radiotherapy. Results: Archival tumor tissue was stained with monoclonal antibodies direc ted against these 4 oncoproteins and scored for staining intensity and perc ent distribution by a pathologist blinded to the patients' clinical outcome s. Frequency of marker expression was 48% for p53, 20% for cyclin D1, 64% f or EGFR, and 41% for VEGF. In multivariate analysis, EGFR positivity was pr otective against locoregional relapse (relative risk [RR], 0.27; 95% confid ence interval [CI], 0.11-0.66; P=.002). In contrast, advanced N stage predi cted poor locoregional relapse-free survival (RR, 1.94, 95% CI, 1.03-3.66; P =.04). Predictors of poor overall survival in multivariate analysis inclu ded VEGF positivity (RR, 3.53; 95% CI, 1.75-7.13; P < .001) and black race (RR, 2.48; 95% CI, 1.05-5.85; P=.04). Cyclin D1 and p53 expression were not significantly associated with prognosis in this cohort. Conclusions: In oral and oropharyngeal squamous cell carcinoma treated with surgery and postoperative radiotherapy, VEGF and EGFR expression may influ ence clinical outcome. If confirmed, these results have potential implicati ons for the determination of patient prognosis and the development of biolo gically based pharmacotherapies.