Correlation of clinicopathological parameters and biological markers related to apoptosis and proliferative activity with a clinical outcome in squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy

Objective: This study was designed to determine whether biological markers related to apoptosis or proliferative activity are associated with the clinical outcome in patients with squamous cell carcinoma (SCC) of the larynx treated with concurrent chemoradiotherapy. Methods: Immunostaining with antibodies specific to p53, bcl-2, bax, and MIB-1 was performed to evaluate expression of these proteins in formalin-fixed, paraffin-embedded specimens of 59 patients treated with concurrent chemoradiotherapy (carboplatin, 100 mg/m2, four to six times every week; total radiation dose of 40–65 Gy over 4–6.5 weeks). Results: Multivariate analysis indicated that nodal status was a significant indicator of overall survival (OS; P=0.001). Patients with bcl-2 positive tumors had better OS than those with bcl-2 negative tumors in both univariate (P=0.002) and multivariate analyses (P<0.001). In the univariate analysis, a considerable difference in OS was observed among the expressions of bax (P=0.077), MIB-1 proteins (P=0.071), and OS, but the difference was not statistically significant. Conclusion: This study indicates that nodal status is the major prognostic factor in patients with SCC of the larynx treated with concurrent chemoradiotherapy. These results provide useful information for predicting prognosis. Further analysis of biological factors is needed to evaluate the value as predictive markers.