title: Serum prognostic biomarkers in head and neck cancer patients.
abstract: OBJECTIVE
  A reliable estimate of survival is important as it may impact treatment choice. The objective of this study is to identify serum autoantibody biomarkers that can be used to improve prognostication for patients affected with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A panel of 130 serum biomarkers, previously selected for cancer detection using microarray-based serological profiling and specialized bioinformatics, were evaluated for their potential as prognostic biomarkers in a cohort of 119 HNSCC patients followed for up to 12.7 years. A biomarker was considered positive if its reactivity to the particular patient's serum was greater than one standard deviation above the mean reactivity to sera from the other 118 patients, using a leave-one-out cross-validation model. Survival curves were estimated according to the Kaplan-Meier method, and statistically significant differences in survival were examined using the log rank test. Independent prognostic biomarkers were identified following analysis using multivariate Cox proportional hazards models.
  
  
  RESULTS
  Poor overall survival was associated with African Americans (hazard ratio [HR] for death = 2.61; 95% confidence interval [CI]: 1.58-4.33; P = .000), advanced stage (HR = 2.79; 95% CI: 1.40-5.57; P = .004), and recurrent disease (HR = 6.66; 95% CI: 2.54-17.44; P = .000). On multivariable Cox analysis adjusted for covariates (race and stage), six of the 130 markers evaluated were found to be independent prognosticators of overall survival.
  
  
  CONCLUSIONS
  The results shown here are promising and demonstrate the potential use of serum biomarkers for prognostication in HNSCC patients. Further clinical trials to include larger samples of patients across multiple centers may be warranted.
authors.affiliation: Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan, U.S.A; Department of Otolaryngology-Head and Neck Surgery, Barbara Ann Karmanos Cancer Institute/Wayne State University, Detroit, Michigan, U.S.A.
authors.forename: Ho-Sheng
authors.initials: HS
authors.lastname: Lin
authors.forename: Fauzia
authors.initials: F
authors.lastname: Siddiq
authors.forename: Harvinder S
authors.initials: HS
authors.lastname: Talwar
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Calin
authors.initials: C
authors.lastname: Voichita
authors.forename: Sorin
authors.initials: S
authors.lastname: Draghici
authors.forename: Gerald
authors.initials: G
authors.lastname: Jeyapalan
authors.forename: Madhumita
authors.initials: M
authors.lastname: Chatterjee
authors.forename: Andrew
authors.initials: A
authors.lastname: Fribley
authors.forename: George H
authors.initials: GH
authors.lastname: Yoo
authors.forename: Seema
authors.initials: S
authors.lastname: Sethi
authors.forename: Harold
authors.initials: H
authors.lastname: Kim
authors.forename: Ammar
authors.initials: A
authors.lastname: Sukari
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Folbe
authors.forename: Michael A
authors.initials: MA
authors.lastname: Tainsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality*; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor
keywords: Head and neck squamous cell carcinoma; prognosis; prognostic biomarkers; proteomic