Prognostic significance of cyclooxygenase-2 in oropharyngeal squamous cell carcinoma.
OBJECTIVE
To determine the relative prognostic significance of cyclooxygenase (COX)-2 expression in patients with oropharyngeal squamous cell carcinoma (SCC).


METHODS
This retrospective cohort study included 82 patients with SCC referred to the Department of Therapeutic Radiology at Yale-New Haven Hospital (Connecticut) between 1980 and 1999 who were treated with primary external beam radiotherapy or gross total surgical resection and postoperative radiotherapy. A microarray of archival tumor tissue was constructed and stained with monoclonal antibodies directed against COX-2 and scored for intensity by a pathologist blinded to the clinical outcomes of the patients. COX-2 immunoreactivity and clinicopathological data were analyzed with respect to survival endpoints using bivariate and multivariate techniques.


RESULTS
Frequency of COX-2 overexpression was 45%. In multivariate analysis, COX-2 positivity predicted poor 3-year survival (P = 0.02; odds ratio = 0.41; 95% confidence interval, 0.20-0.84). Increasing age was significantly associated with increased 3-year survival (P = 0.03; odds ratio = 1.04; 95% confidence interval, 1.004-1.09). Positive COX-2 status trended toward predicting decreased 3-year disease-free survival.


CONCLUSIONS
COX-2 was the most important predictor of poor survival in this patient cohort. In patients with oropharyngeal SCC treated with external-beam radiation therapy, overexpression of COX-2 may affect clinical outcome, and COX-2 may therefore prove valuable both as a prognostic factor and as a therapeutic target.
Chang
Bryan W
BW
Department of Therapeutic Radiology, Yale University, New Haven, Connecticut 06520-8040, USA.
Kim
David H
DH
Kowalski
Diane P
DP
Burleson
Joseph A
JA
Son
Yung H
YH
Wilson
Lynn D
LD
Haffty
Bruce G
BG
D002294:Carcinoma, Squamous Cell / Q000201:enzymology* / Q000235:genetics / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D015331:Cohort Studies; D051546:Cyclooxygenase 2; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007527:Isoenzymes / Q000378:metabolism*; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases