title: Postoperative radiotherapy for laryngeal carcinoma: the prognostic role of subcellular Maspin expression.
abstract: OBJECTIVE
  Reported outcomes of postoperative radiotherapy (PORT) for laryngeal squamous cell carcinoma (LSCC) have varied and sometimes been disappointing. The aim of the present preliminary study was to investigate whether a given immunohistochemical pattern of Maspin expression in laryngeal carcinoma cells could be prognostically associated with response to PORT.
  
  
  METHODS
  Thirty-two consecutive patients treated for LSCC with primary surgery and PORT. The subcellular (nuclear vs non-nuclear) pattern of Maspin expression was assessed immunohistochemically on LSCC surgical specimens and analyzed in relation to recurrence rate (RR) and disease-free survival (DFS).
  
  
  RESULTS
  A non-nuclear Maspin expression was found in 23 of 32 cases (72%), and all recurrences (17 cases) occurred in this subgroup of patients. A non-nuclear Maspin expression was strongly associated with recurrence [p = 0.0002, hazard ratio (HR) 5.58] and a shorter DFS (p = 0.0004) after PORT for LSCC. Even in N0 patients, a non-nuclear Maspin expression was associated with a significantly higher RR (p = 0.04, HR 1.42) and a shorter DFS (p = 0.02). Among the common clinic-pathological parameters considered, only N stage showed a trend toward an association with prognosis in terms of DFS (p = 0.08).
  
  
  CONCLUSIONS
  Assessing subcellular patterns of Maspin expression in LSCC specimens could identify patients less likely to respond to PORT, who might benefit from combined chemo-radiotherapy to improve the efficacy of adjuvant protocols.
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy. Electronic address: marcolionello@email.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Lionello
authors.affiliation: Department of Medicine, DIMED, University of Padova, Padova, Italy.
authors.forename: Stella
authors.initials: S
authors.lastname: Blandamura
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Treviso Branch, University of Padova, Treviso, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Staffieri
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Tealdo
authors.affiliation: Department of Medicine, DIMED, University of Padova, Padova, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Marchese Ragona
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: de Filippis
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Staffieri
authors.affiliation: Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000235:genetics / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D011184:Postoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D015843:Serpins / Q000235:genetics*; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: C085344:SERPIN-B5; D015843:Serpins