title: Relationship between anti-apoptotic proteins survivin and Bcl-2, and response to treatment in patients undergoing post-operative RT for laryngeal cancer: a pilot study.
abstract: BACKGROUND
  Clinicopathological research has focused on identifying molecular and biological prognostic factors for laryngeal carcinoma (LSCC) treated with post-operative radiotherapy (RT). The aim of this study was to assess the prognostic importance of anti-apoptotic proteins survivin and B-cell lymphoma-2 (Bcl-2) in a series of patients with LSCC who had primary surgery followed by RT.
  
  
  METHODS
  Thirty-three consecutive patients who underwent primary surgery followed by RT were considered. Survivin nuclear and cytoplasmic expressions and Bcl-2 expression were determined immunohistochemically.
  
  
  RESULTS
  The loco-regional recurrence rate was significantly higher among LSCC patients with a nuclear survivin expression >10.0% (P = 0.029), and their disease-free survival (DFS) was shorter than in cases whose nuclear survivin expression was ≤10.0% (P = 0.002). DFS was significantly shorter in cases with a Bcl-2 expression >2.0% than in those whose Bcl-2 expression was ≤2.0% (P = 0.035).
  
  
  CONCLUSIONS
  Nuclear survivin expression and Bcl-2 expression warrant further investigation as potential predictive biomarkers to enable individualized treatments (e.g. post-operative chemo-radiotherapy instead of RT alone for patients whose LSCCs strongly express nuclear survivin or/and Bcl-2). This preliminary evidence justifies the design of new studies on the association of agents targeting survivin and Bcl-2 with conventional chemotherapeutic agents and RT for advanced LSCC.
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, 35128 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: Marco
authors.initials: M
authors.lastname: Lionello
authors.forename: Giulia
authors.initials: G
authors.lastname: Tealdo
authors.forename: Claudia
authors.initials: C
authors.lastname: Staffieri
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Friso
authors.forename: Roberto
authors.initials: R
authors.lastname: Stramare
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ottaviano
authors.forename: Stella
authors.initials: S
authors.lastname: Blandamura
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D002467:Cell Nucleus / Q000648:ultrastructure; D003593:Cytoplasm / Q000648:ultrastructure; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009363:Neoplasm Proteins / Q000032:analysis*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010865:Pilot Projects; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis*; D012372:ROC Curve; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012680:Sensitivity and Specificity; D000077022:Survivin; D016896:Treatment Outcome
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D000077022:Survivin