title: Apoptosis inhibitor showed a significant prognostic marker of relapsed oral cavity cancer after the curative resection surgery.
abstract: BACKGROUND
  Recurrence of oral cavity cancer after curative resection remains a major problem. Pathologic markers, which include positive margins, extracapsular nodal extension, lymphovascular invasion, and perineural invasion, predict likelihood of recurrence. However, there currently are no biomarkers that can be used to follow patients following the curative resection. Survivin, the anti-apoptotic protein is up-regulated in many types of cancer and is associated with poor prognosis and recurrence of cancer. We explored whether this biomarker predicted disease recurrence after curative resection of oral cancers.
  
  
  METHODS
  Retrospective study of 47 patients with oral cancers who underwent curative surgery. Cases were assigned into two groups for analysis, with or without loco-regional recurrence/distant metastases. The study protocol was approved by the ethics committee of the National Cancer Institute. Biopsy sections both at tumor and margin were studied for expression of survivin and the tumor marker, CD44v6 by immunohistochemistry (IHC) technique.
  
  
  RESULTS
  By using a scoring system, the surgical margin of the recurrent group showed a higher survivin score than nonrecurrent group (p = 0.003). Interestingly, the primary tumor of the recurrent group showed a markedly higher survivin score than the non-recurrent group (p< 0.001). By contrast, the CD44v6 scores of the primary and the margins showed no significant difference between either group.
  
  
  CONCLUSIONS
  The present study suggests that monitoring the survivin expression at the surgical margin may serve as a biomarker to evaluate the adequacy of the surgical margin and may serve to provide information to prepare a better preoperative plan for oral cancer surgery in order to improve the curative outcome.
authors.affiliation: Clinical Research Center National Cancer Institute of Thailand, Bangkok, Thailand. wlausoon@yahoo.com
authors.forename: Wirote
authors.initials: W
authors.lastname: Lausoontornsiri
authors.forename: Somjin
authors.initials: S
authors.lastname: Chindavijak
authors.forename: Ekapob
authors.initials: E
authors.lastname: Sangariyavanich
authors.forename: Anantnuch
authors.initials: A
authors.lastname: Sakapiboonnan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism*; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D009363:Neoplasm Proteins / Q000378:metabolism*; D009364:Neoplasm Recurrence, Local / Q000378:metabolism*; D010865:Pilot Projects; D011379:Prognosis; D012189:Retrospective Studies; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D015415:Biomarkers; C497483:CD44 protein, human; D018960:Hyaluronan Receptors; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D000077022:Survivin