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07-09-2011 | General practice | Article

Biomarkers improve oral squamous cell carcinoma survival prediction


Free abstract

MedWire News: The ability of nomograms to predict survival in patients with oral squamous cell carcinoma (OSCC), as well as help choose appropriate adjuvant treatment, is improved by the incorporation of biomarkers, conclude Korean scientists.

The 5-year survival rates of patients with OSCC remain relatively poor despite the availability of advanced clinical diagnostic systems, including computed tomography, magnetic resonance imaging, and improved therapy. Prognostic tools that accurately predict OSCC outcome are therefore required.

As the inclusion of biomarkers has improved the accuracy of predictive nonograms in other forms of cancer, In-Ho Cha and colleagues from Yonsei University in Seoul studied 96 patients with primary OSCC who underwent surgical resection between 1994 and 2003.

Immunohistochemical staining was used to determine levels of p53, insulin-like growth factor II mRNA-binding protein (IMP)3, cyclo-oxygenase (COX)2, and RNA-binding protein, human antigen R (HuR) in tumor samples obtained from the patients at surgery.

As expected, tumor site, lymph node metastasis (LNM), and T classification were significantly and differentially distributed between early and advanced-stage groups. Only IMP3 was significantly associated with LNM, grade, T classification, and P stage. HuR expression in cytoplasm was significantly associated with LNM.

IMP3 was a significantly factor for predicting OSCC survival, at a hazard ratio of 2.87 on multivariate analysis, while p53 was nonsignificantly associated with survival. Interestingly, however, the impact of p53 was significant in the presence of negative IMP3.

Constructing a nomogram for predicting 5- and 10-year survival with clinical factors, IMP3 and p53 expression revealed that the c-index with biomarkers included was 0.697 compared with 0.656 when biomarkers were excluded.

The team writes in the journal Head and Neck: "This is the first prognostic nomoogram that was able to predict the survival of Korean patients with OSCC. The constructed nomogram could be improved by including more data and other biological candidates in the predictive model."

By Liam Davenport

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