title: Elderly patients at higher risk of laryngeal carcinoma recurrence could be identified by a panel of two biomarkers (nm23-H1 and CD105) and pN+ status.
abstract: Laryngeal squamous cell carcinoma (LSCC) recurrences are very difficult to manage in elderly patients (age ≥65 years), because treatment carries significant morbidity and mortality. The aim of this study was to develop a panel of parameters (clinicopathological variables or biomarkers) to improve our ability to detect elderly patients at higher risk of LSCC recurrence. Maspin, nm23-H1, and CD105 were investigated using immunohistochemistry on surgical specimens from 46 elderly patients treated for LSCC. After univariate analysis identified parameters associated with LSCC recurrence, a multivariate prognostic model was constructed. At univariate analysis, a higher recurrence rate was significantly associated with nm23-H1 nuclear expression in carcinoma cells ≤2.0% (p = 0.01), CD105 expression in intratumoral vascular endothelial cells ≥5.28% (p = 0.04), and pN+ status (p = 0.04). Multivariate modeling confirmed that nuclear nm23-H1 ≤2.0% (p = 0.009) and CD105 ≥5.28% (p = 0.013) had a negative prognostic significance in terms of disease recurrence, while pN+ status showed a trend toward significance (p = 0.05). We thus obtained a panel comprising two biomarkers and neck lymph node status that revealed an excellent discriminatory power [AUC (ROC) of 0.81] in terms of the risk of LSCC recurrence. The panel achieved a specificity of 96% and a positive predictive value of 93%. We identified a panel with an excellent discriminatory power in identifying elderly patients at higher risk of recurrence after treatment for LSCC. These patients would benefit from a more aggressive primary treatment.
authors.affiliation: Otolaryngology Section, Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lovato
authors.affiliation: Otolaryngology Section, Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128, Padua, Italy. gino.marioni@unipd.it.
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.affiliation: Department of Medicine DIMED, University of Padova, Padua, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.affiliation: Otolaryngology Section, Department of Neurosciences, Treviso Hospital Branch, University of Padova, Padua, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Staffieri
authors.affiliation: Department of Medicine DIMED, University of Padova, Padua, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: ENT Department, University of Rome "La Sapienza", Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ralli
authors.affiliation: Otolaryngology Section, Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
authors.affiliation: Department of Medicine DIMED, University of Padova, Padua, Italy.
authors.forename: Stella
authors.initials: S
authors.lastname: Blandamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D000071063:Endoglin; D042783:Endothelial Cells / Q000378:metabolism; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000378:metabolism* / Q000473:pathology; D008297:Male; D054778:NM23 Nucleoside Diphosphate Kinases / Q000378:metabolism*; D009364:Neoplasm Recurrence, Local / Q000378:metabolism*; D011956:Receptors, Cell Surface / Q000378:metabolism*
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor; C064206:ENG protein, human; D000071063:Endoglin; D054778:NM23 Nucleoside Diphosphate Kinases; D011956:Receptors, Cell Surface; C517938:NME1 protein, human
keywords: Biomarkers; Elderly; Laryngeal carcinoma; Panel; Prognosis