title: External validation of sTWEAK as a prognostic noninvasive biomarker for head and neck squamous cell carcinoma.
abstract: The main purpose of this study was to validate the prognostic significance of tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) in head and neck squamous cell carcinoma (HNSCC) using an independent cohort.
  
  
  
  Data were evaluated from 153 patients with HNSCC in stages III to IV, who received radiotherapy (RT) or chemoradiotherapy. We quantified soluble TWEAK (sTWEAK) in pretreatment samples using enzyme-linked immunosorbent assay.
  
  
  
  The classification tree revealed a cutoff value of 322 pg/mL for sTWEAK to be ideal for discriminating between patients' disease control. Kaplan-Meier curves indicate that the disease-free survival rate in patients with high sTWEAK was significantly higher than in patients with low levels (p = .006, log-rank test). An independent link was identified between low sTWEAK and poor clinical outcome in Cox regression multivariate analysis (hazard ratio = 1.866; 95% confidence interval [CI] = 1.114-3.125; p = .001).
  
  
  
  Our study highlights the significance of this noninvasive biomarker in the discrimination according to the disease control achieved by patients who received a nonsurgical organ-preservation treatment. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1358-E1363, 2016.
authors.affiliation: MoBioFood Research Group, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, Campus Sescel·lades, Tarragona, Spain.
authors.forename: Ximena
authors.initials: X
authors.lastname: Terra
authors.affiliation: Radiation Oncology Department, Hospital Sant Joan de Reus, Reus, Tarragona, Catalonia.
authors.forename: David
authors.initials: D
authors.lastname: Gómez
authors.affiliation: Otorhinolaryngology Head-Neck Surgery Department, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.|Laboratory of Angiology, Vascular Biology and Inflammation, Institute of Biomedical, Research (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jacinto
authors.initials: J
authors.lastname: García-Lorenzo
authors.affiliation: Otorhinolaryngology Head-Neck Surgery Department, Hospital Universitari de Tarragona Joan XXIII, Insitut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Tarragona, Catalonia.
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Flores
authors.affiliation: Otorhinolaryngology Head-Neck Surgery Department, Hospital Universitari de Tarragona Joan XXIII, Insitut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Tarragona, Catalonia.|HJ23 Otolaryngology Disease Research Group, Insitut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Catalonia.
authors.forename: Enric
authors.initials: E
authors.lastname: Figuerola
authors.affiliation: Biochemestry Department, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Mora
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital Universitari Joan XXIII de Tarragona, Insitut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Spain.
authors.forename: Matilde R
authors.initials: MR
authors.lastname: Chacón
authors.affiliation: Otorhinolaryngology Head-Neck Surgery Department, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Quer
authors.affiliation: Laboratory of Angiology, Vascular Biology and Inflammation, Institute of Biomedical, Research (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Otorhinolaryngology Head-Neck Surgery Department, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.|Laboratory of Angiology, Vascular Biology and Inflammation, Institute of Biomedical, Research (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain.|Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN, MICINN, ISCIII), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: León
authors.affiliation: Otorhinolaryngology Head-Neck Surgery Department, Hospital Universitari de Tarragona Joan XXIII, Insitut d'Investigació Sanitària Pere Virgili (IISPV), Universitat Rovira i Virgili, Tarragona, Catalonia.|HJ23 Otolaryngology Disease Research Group, Insitut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Catalonia.
authors.forename: Francesc Xavier
authors.initials: FX
authors.lastname: Avilés-Jurado
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D000074049:Cytokine TWEAK / Q000097:blood*; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D000074049:Cytokine TWEAK; C109743:TNFSF12 protein, human
keywords: disease-free survival; noninvasive biomarker; prognosis; soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK); treatment