title: Prognostic and predictive significance of p53, EGFr, Ki-67 in larynx preservation treatment.
abstract: BACKGROUND
  The optimal management of advanced laryngeal and hypopharyngeal cancers (L&HC) must involve consideration of both survival and functional effect of the given treatment approach. Despite over two decades of investigations of several treatment options, including surgery, radiotherapy, chemotherapy or some combinations thereof, little consensus exists as to which treatment offers the best survival, together with functional speech and swallowing.
  
  
  OBJECTIVE
  To determine predictive and prognostic value of p53, EGFr, Ki-67 in patients with advanced laryngeal and hypopharyngeal cancer, treated with larynx preservation intent.
  
  
  METHODS
  Thirty-three patients received 2-3 cycles of induction chemotherapy (ICHT) consisting of cisplatin and fluoruracil and underwent subsequent radical radiotherapy. Immunohistochemical analyzes of p53, EGFr and Ki-67 were performed.
  
  
  RESULTS
  Response to ICHT was obtained in 24 patients (75%). Better response to ICHT was correlated only with EGFr expression (p = 0.04, RR = 1.91). The 5-year loco-regional control (LRC) and disease-specific survival (DSS) rates were 48% and 57%, respectively. The 5-year larynx preservation rate was 68% in responders to ICHT compared to 21% in non-responders (p = 0.02). It was also higher in patients without EGFr expression (but not significantly, p = 0.43).
  
  
  CONCLUSIONS
  Lack of EGFr expression is a favorable predictive factor for response to ICHT. Neither p53 nor Ki-67 have predictive and prognostic value in larynx preservation treatment.
authors.affiliation: Department of Radiation Oncology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Małecki
authors.affiliation: Department of Radiation Oncology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Gliński
authors.affiliation: Department of Radiation Oncology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Mucha-Małecka
authors.affiliation: Department of Pathology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Ryś
authors.affiliation: Department of Pathology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kruczak
authors.affiliation: Department of Radiation Oncology, Center of Oncology, Bydgoszcz, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Roszkowski
authors.affiliation: Department of Clinical Oncology, The Rydygier Hospital, Kraków, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Urbańska-Gąsiorowska
authors.affiliation: Department of Radiation Oncology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Hetnał
keywords: EGFr; Induction chemotherapy; Ki-67; Larynx preservation; p53