title: mTOR expression and prognosis in elderly patients with laryngeal carcinoma: uni- and multivariate analyses.
abstract: Cancer is common in the elderly, who may also be frail, which can complicate the choice of the best therapeutic approach. We sought to examine whether the serine-threonine kinase mTOR, a "master switch" in cancer cells that modulates metabolism, the cell cycle, and apoptosis, might help in clinical decision-making. The aim of the present study was thus to assess the potential prognostic role of mTOR in elderly patients with laryngeal carcinoma (LSCC). mTOR expression was determined immunohistochemically in 54 consecutive elderly (≥65 years old) patients with LSCC. On univariate analysis, nodal involvement and pathological stage correlated strongly with the elderly LSCC patients' prognosis in terms of disease recurrence rate and disease-free survival (DFS). Patients whose mTOR expression was >35.3% had a significantly higher recurrence rate (p=0.003) and shorter DFS (p=0.013). In the multivariate model, N status (p=0.001) and mTOR expression (p=0.026) maintained an independent prognostic significance in relation to DFS. mTOR probably influences the aggressive LSCC phenotype in elderly patients and its expression in elderly LSCC cases can be considered a prognostic marker potentially useful for identifying patients at higher risk of disease recurrence, and N0 patients at higher risk of recurrence who may benefit from more aggressive treatment. Since rapalogs (as mTOR inhibitors) might have an effect on LSCC, further investigations are needed to ascertain these agents' role in therapeutic strategies for advanced LSCC in elderly patients.
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy. gino.marioni@unipd.it
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
authors.forename: Lucia
authors.initials: L
authors.lastname: Lora
authors.forename: Salvatore
authors.initials: S
authors.lastname: Fermo
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.forename: Fabio Biagio
authors.initials: FB
authors.lastname: La Torre
authors.forename: Niccolò
authors.initials: N
authors.lastname: Favaretto
authors.forename: Elisa
authors.initials: E
authors.lastname: Valentini
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Stella
authors.initials: S
authors.lastname: Blandamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000628:therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000378:metabolism* / Q000628:therapy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D058570:TOR Serine-Threonine Kinases / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases