title: Prognostic impact of the epidermal growth factor receptor levels for patients with larynx and hypopharynx cancer.
abstract: The aim of this study was to analyse prognostic factors for disease free interval (DFI) and overall survival (OS) among patients with larynx and hypopharynx cancer requiring a total laryngectomy. Three groups of patients were studied according to the type of treatment they received. Fifty-eight patients had total laryngectomy, 71 patients had organ preservation treatment including induction chemotherapy followed by exclusive radiotherapy, 26 patients received induction chemotherapy followed by salvage total laryngectomy. The studied potential prognostic factors were age, gender, performans status, primary tumor localization, T status, N status, tumor volume and tumoral EGFR level (fmol/mg protein). The multivariate analysis showed that both N status and tumor volume were significant for DFI and OS. EGFR level was significant only for patients treated by induction chemotherapy and exclusive radiotherapy (p = 0.05 and 0.05 for DFI and OS length, respectively). Among this group, patients with tumor EGFR levels lower and higher than 100 fmol/mg protein had 53% versus 22% and 51% versus 18% 5-year of DFI and OS rates, respectively (Log rank test: p = 0.001 and 0.0001). EGFR determination appears to be a powerful prognostic parameter for patients treated by induction chemotherapy followed by exclusive radiotherapy. Laryngectomy seems to erase the prognostic impact of EGFR expression. These results profile the use of EGFR targeting therapy for this category of patients.
authors.affiliation: Department of Medical Oncology, CHU J. Minjoz, 25030 Besancon Cedex, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Pivot
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Guardiola
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.forename: Olivier
authors.initials: O
authors.lastname: Dassonville
authors.forename: Mireille
authors.initials: M
authors.lastname: Francoual
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Formento
authors.forename: René-Jean
authors.initials: RJ
authors.lastname: Bensadoun
authors.forename: François
authors.initials: F
authors.lastname: Demard
authors.forename: Maurice
authors.initials: M
authors.lastname: Schneider
authors.forename: Gérard
authors.initials: G
authors.lastname: Milano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000032:analysis*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000737:chemistry* / Q000188:drug therapy / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000737:chemistry* / Q000188:drug therapy / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D066246:ErbB Receptors