P53 EXPRESSION AND CELL-PROLIFERATION AS PROGNOSTIC FACTORS IN LARYNGEAL SQUAMOUS-CELL CARCINOMA

Purpose: To investigate the prognostic significance of p53 expression and proliferation markers in primary laryngeal squamous cell carcinoma . Patients and Methods: Primary tumors for analyses were obtained pati ents, with complete followup data. All patients were treated between t he years 1975 and 1990. The expression of p53 was analyzed with monocl onal D07 antibody and proliferative activity with Ki-67 (MIB-1) and PC NA (monoclonal 19A2) antibodies. Volume corrected mitotic (M/V) index and histological grade were determined in hematoxylin and eosin-staine d slides. Results: Sixty-eight percent of the tumors overexpressed p53 . During a median follow-up of 62 months, 41 (40%) of patients relapse d. In univariate analysis site of the primary tumor, stage, p53 expres sion, histologic grade, and M/V index were significant predictors of d isease-free survival. In multivariate analysis, only M/V index was a s tatistically significant predictor of disease-free survival. Overall s urvival was significantly better for those overexpressing p53 (10-year cumulative survival rate 68% v 44%, P = .004). In multivariate analys is, M/V index (P = .02), 953 (P = .02), and stage (P = .007) were stat istically significant predictors of overall survival. When this analys is includes stratification according to the type of treatment received , M/V index (P = .007), stage (P = .0002), and 953 (P = .006) were eve n more significant predictors of overall survival. No association betw een p53 status and proliferative activity was found. Conclusion: Overe xpression of p53 is associated with favorable disease-free and overall survival in laryngeal squamous cell carcinoma. It may also have an in dependent prognostic value in laryngeal cancer. M/V index, p53 overexp ression, and stage predict with significant accuracy the 10-year overa ll survival. (C) 1997 by American Society of Clinical Oncology.