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High perioperative level of oxidative stress as a prognostic tool for identifying patients with a high risk of recurrence of head and neck squamous cell carcinoma

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Abstract

Background

The aim of the study was to investigate the relationships among (a) glutathione peroxidase (GPx) and malondialdehyde (MDA); (b) oncological characteristics (i.e., TNM classification, tumor grade), and; (c) prognosis of head and neck squamous cell carcinoma.

Methods

In a prospective cohort study, we followed 88 patients for 67.4 months (median 40.3) after surgery for head and neck squamous cell carcinoma. Activity of GPx was determined by ELISA and plasma MDA concentration by liquid chromatography.

Results

Lower GPx activity was observed in the T3/4 patients than in the T1/2 group. Tumor grade was significantly correlated with both GPx (P = 0.001) and MDA (P = 0.05, both Spearman). The perioperative level of MDA was higher in patients who later recurred during the follow-up period (n = 15) than in the complete remission group (P = 0.01, Mann–Whitney). Median disease-free interval and overall survival in the group with MDA > median were 29.5 and 32.0 months, respectively, and 38.4 and 40.3 months in the patient group with MDA ≤ median (P = 0.10 and P = 0.08, respectively; Kaplan–Meier). Patients with MDA levels higher than the median had a more than twofold greater risk of recurrence than patients with MDA levels smaller than the median (31.3 vs. 15.2%, P = 0.06, logrank).

Conclusion

Our results suggest that an increased MDA level at the time of initial surgery is found in patients with a high risk of recurrence, which suggests that each patient can be categorized according to risk of recurrence based on their MDA level at the time of initial surgery.

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Abbreviations

AOE:

Antioxidative enzymes

CR:

Complete remission

DFI:

Disease-free interval

HNSCC:

Head and neck squamous cell carcinoma

GPx:

Glutathione peroxidase

ery-GPx:

Glutathione peroxidase in erythrocytes

p-GPx:

Glutathione peroxidase in plasma

MDA:

Malondialdehyde

OAS:

Overall survival

ROS:

Reactive oxygen species

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Acknowledgments

This project is supported by grant no. 10/II NR/9200-3 from The Internal Grant Agency of The Ministry of Health of the Czech Republic, Prague. The study was conducted in accord with the Helsinki Declaration of 1964 and all subsequent revisions of it, and was approved by the ethical committee of St. Anne’s Faculty Hospital, Brno, Czech Republic.

Conflict of interest statement

None to declare.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, St. Anne’s Faculty Hospital, Pekařská 53, 656 91, Brno, Czech Republic

    Richard Salzman, Zuzana Horáková, Eva Tóthová & Rom Kostřica

  2. Department of Pathophysiology, Faculty of Medicine, Masaryk University, Komenského nám. 2, 662 43, Brno, Czech Republic

    Lukáš Pácal & Kateřina Kaňková

  3. Department of Biochemistry, Faculty of Medicine, Masaryk University, Komenského nám. 2, 662 43, Brno, Czech Republic

    Josef Tomandl

Authors
  1. Richard Salzman
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  2. Lukáš Pácal
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  3. Kateřina Kaňková
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  4. Josef Tomandl
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  5. Zuzana Horáková
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  6. Eva Tóthová
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  7. Rom Kostřica
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Corresponding author

Correspondence to Richard Salzman.

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Salzman, R., Pácal, L., Kaňková, K. et al. High perioperative level of oxidative stress as a prognostic tool for identifying patients with a high risk of recurrence of head and neck squamous cell carcinoma. Int J Clin Oncol 15, 565–570 (2010). https://doi.org/10.1007/s10147-010-0108-z

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  • DOI: https://doi.org/10.1007/s10147-010-0108-z

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