title: Association between high collagenase-3 expression levels and poor prognosis in patients with head and neck cancer.
abstract: BACKGROUND
  Squamous cell carcinoma of the head and neck (HNSCC) is a common cancer type. The ability for curative treatment with surgery and radiotherapy (RT) is usually highly dependent on tumor stage at the time of diagnosis.
  
  
  METHODS
  The purpose of this study was to determine whether the expression of a cancer-specific proteinase, collagenase-3 (matrix metalloproteinase-13 [MMP-13]), is associated with survival parameters in patients with HNSCC. We studied MMP-13 expression in tumors of 81 patients with stage I-IV HNSCC treated with surgery alone or in combination with radiotherapy.
  
  
  RESULTS
  We found a subgroup of patients with high MMP-13 expression level in their tumors (>/=90% MMP-13-positive tumor cells) associated with unfavorable prognosis (median overall survival [OS], 11.8 vs 19.6 months, p = .032). In addition, the median disease-specific survival (DSS) time was markedly reduced in this subgroup (13.8 months vs 40.7 months, p = .062). When the subgroup of patients treated with a curative intent was studied, the same association was found in OS (13.8 vs 24.6 months, p = .023) and DSS (p = .004). In addition, there was a trend for association between >/=90% MMP-13 positivity and a recurrent tumor (p = .078) in curatively treated patients.
  
  
  CONCLUSIONS
  The short survival time associated with high MMP-13 expression levels could not be predicted by tumor size or local lymph node invasion. These results show that a high MMP-13 expression level is associated with aggressiveness of HNSCC and may have prognostic value in patient evaluation.
authors.affiliation: Department of Oncology and Radiotherapy, Turku University Hospital, P.O. Box 52, FIN-20521 Turku, Finland.
authors.forename: Marjaana
authors.initials: M
authors.lastname: Luukkaa
authors.forename: Pia
authors.initials: P
authors.lastname: Vihinen
authors.forename: Pauliina
authors.initials: P
authors.lastname: Kronqvist
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.forename: Seppo
authors.initials: S
authors.lastname: Pyrhönen
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Kähäri
authors.forename: Reidar
authors.initials: R
authors.lastname: Grénman
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000201:enzymology* / Q000401:mortality / Q000628:therapy; D017364:Collagenases / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D053509:Matrix Metalloproteinase 13; D009062:Mouth Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000201:enzymology; D010610:Pharyngeal Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant
chemical_list: D017364:Collagenases; C507079:MMP13 protein, human; D053509:Matrix Metalloproteinase 13