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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

  • Head and Neck
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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.

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Acknowledgments

This study was partly supported by Grant No. 60A07-8485/13 (G. Marioni) from the University of Padova, Italy. The authors thank Frances Coburn for correcting the English version of this paper.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Otolaryngology Section, Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128, Padua, Italy

    Andrea Lovato, Gino Marioni & Alberto Staffieri

  2. Department of Medicine DIMED, University of Padova, Padua, Italy

    Enzo Manzato, Luciano Giacomelli & Stella Blandamura

  3. Otolaryngology Section, Department of Neurosciences, Treviso Hospital Branch, University of Padova, Padua, Italy

    Claudia Staffieri

  4. ENT Department, University of Rome “La Sapienza”, Rome, Italy

    Giovanni Ralli

Authors
  1. Andrea Lovato
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  2. Gino Marioni
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  3. Enzo Manzato
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  4. Claudia Staffieri
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  5. Luciano Giacomelli
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  6. Giovanni Ralli
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  7. Alberto Staffieri
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  8. Stella Blandamura
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Corresponding author

Correspondence to Gino Marioni.

Additional information

Giovanni Ralli is the founding member of the Italian Association of Geriatric Otolaryngology.

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Lovato, A., Marioni, G., Manzato, E. et al. 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. Eur Arch Otorhinolaryngol 272, 3417–3424 (2015). https://doi.org/10.1007/s00405-014-3310-1

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  • DOI: https://doi.org/10.1007/s00405-014-3310-1

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