title: Indications for postoperative radiotherapy in laryngeal carcinoma: a panel of tumor tissue markers for predicting locoregional recurrence in surgically treated carcinoma. A pilot study.
abstract: BACKGROUND
  Combining primary surgery with postoperative radiotherapy (RT) significantly reduces locoregional recurrence rates in selected patients with laryngeal squamous cell carcinoma (SCC). A prognostic model was used to see if associating laryngeal SCC tissue markers (mammary serine protease inhibitor [MASPIN], CD105, angiogenin [ANG], and nm23-H1) with conventional criteria could better discriminate higher-risk patients warranting postoperative RT.
  
  
  METHODS
  The study involved 76 consecutively operated patients with laryngeal SCC not recommended for postoperative RT, in accord with current guidelines.
  
  
  RESULTS
  On multivariate statistical modeling, non-nuclear MASPIN expression (p = .022), a CD105 expression ≥ 5.28% in vascular endothelial cells (p = .003), an nm23-H1 nuclear expression in carcinoma cells ≤ 12.0% (p = .028), and an ANG expression ≥ 5.0% (p = .07, statistical trend) showed a negative prognostic significance. The discriminatory power for disease recurrence of the 4 considered biomarkers generated an area under the curve (AUC; receiver operating characteristic [ROC]) of 0.872. The Hosmer-Lemeshow scale indicated an excellent discriminatory power.
  
  
  CONCLUSIONS
  This panel's ability to predict laryngeal SCC recurrence warrants further prospective, randomized studies to assess its use among the parameters routinely considered before recommending postoperative RT for patients with laryngeal SCC.
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.forename: Stella
authors.initials: S
authors.lastname: Blandamura
authors.forename: Marco
authors.initials: M
authors.lastname: Lionello
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Lovato
authors.forename: Niccolò
authors.initials: N
authors.lastname: Favaretto
authors.forename: Stefano
authors.initials: S
authors.lastname: Breda
authors.forename: Giulia
authors.initials: G
authors.lastname: Tealdo
authors.forename: Vincenza
authors.initials: V
authors.lastname: Guzzardo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Ottaviano
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054778:NM23 Nucleoside Diphosphate Kinases / Q000097:blood; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D018714:Radiotherapy, Adjuvant; D012259:Ribonuclease, Pancreatic / Q000097:blood; D012680:Sensitivity and Specificity; D015843:Serpins / Q000097:blood; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D054778:NM23 Nucleoside Diphosphate Kinases; C085344:SERPIN-B5; D015843:Serpins; C517938:NME1 protein, human; C046366:angiogenin; D012259:Ribonuclease, Pancreatic
keywords: CD105; angiogenin; laryngeal carcinoma; mammary serine protease inhibitor (MASPIN); markers panel; nm23-H1; postoperative radiotherapy (RT)