Factors predicting outcome after salvage treatment for stage IV oral squamous cell carcinoma: Evidence of the potential importance of the cyclooxygenase-2-prostaglandin E2 pathway.
BACKGROUND
We determined the clinicopathological factors that predicted outcome after salvage treatment for stage IV oral squamous cell carcinoma (OSCC). Additionally, the prognostic significance of the cyclooxygenase-2 (COX-2)/microsomal prostaglandin-E synthase-1 (mPGES-1) pathway was evaluated.


METHODS
Thirty-one patients who underwent salvage surgery were included. COX-2 and mPGES-1 levels were quantified by real time polymerase chain reaction (PCR).


RESULTS
The 2-year disease-free and overall survival rates were 46% and 53%, respectively. Adequacy of initial treatment, tobacco smoking, and the presence of pathological risk factors were predictive of mortality. In patients who had not received chemotherapy before salvage surgery, high levels of intratumoral COX-2 and mPGES-1 were associated with poor prognosis. By contrast, high intratumoral COX-2 and mPGES-1 after chemotherapy were associated with improved outcomes.


CONCLUSIONS
Clinicopathological factors may inform treatment decisions in patients with stage IV OSCC. Expression patterns of COX-2 and mPGES-1 correlated with outcome and warrant further investigation. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1142-1149, 2015.
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Vikram D
VD
Kekatpure
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Mandeep
M
Singh
Department of Biostatistics, St. John's Research Institute, Bangalore, India.
Sumithra
S
Selvam
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Girish
G
Shetkar
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Naveen C
NC
Hedne
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Nirav P
NP
Trivedi
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Gangotri
G
Siddappa
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Sindhu V
SV
Govindan
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Amritha
A
Suresh
Department of Medical Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Bharath
B
Rangarajan
Department of Medicine, Weill Medical College of Cornell University, New York, New York.
Andrew J
AJ
Dannenberg
Department of Head and Neck Oncology, Mazumdar-Shaw Cancer Center, Narayana Hrudayalaya, Health City, Bangalore, India.
Moni Abraham
MA
Kuriakose
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D051546:Cyclooxygenase 2 / Q000235:genetics / Q000378:metabolism*; D005260:Female; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D000071876:Prostaglandin-E Synthases; D016879:Salvage Therapy / Q000379:methods; D012680:Sensitivity and Specificity; D015398:Signal Transduction
D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2; D019746:Intramolecular Oxidoreductases; C000605862:PTGES protein, human; D000071876:Prostaglandin-E Synthases
cyclooxygenase-2 (COX-2); microsomal prostaglandin-E synthase-1 (mPGES-1); oral cavity; recurrent squamous cell carcinoma (SCC); salvage surgery