Introduction: The outcome of 500 patients undergoing surgery for oral squamous cell carcinoma (OSCC) was evaluated in order to identify the prognostic value of several factors. Risk factors, tissue and biological markers (MET proto-oncogene, S phase kinase-associated protein-Skp2) have also been taken into consideration as possible indicators of tumour aggressiveness and predictors of the carcinogenic process and metastatic capability. Methods: A total of 500 patients were studied who had undergone surgery for OSCC between 1989 and 2011. For each patient, personal data, alcohol and tobacco con- sumption, symptoms, histological findings, treatment and outcome were recorded and analyzed statistically. Survival curves were calculated using the Kaplan–Meier algorithm, and the difference in survival among subgroups was examined. The role of S phase kinase-associated protein (Skp2) and of MET gene mutations was investigated in 71 and 12 patients respectively. Results : The differences in the 5-year survival were sig- nificant for the site of origin, N and pN status, TNM stage groups, grading, status of the resection margins, osseous infiltration, and perineural invasion. Vascular involvement was not statistically significant. In patients undergoing radiation therapy, only perineural invasion negatively influenced the 5-year survival prognosis. Nine of the seventeen patients with Skp2 positive nuclei (≥20%) developed nodal metastasis. Conversely, only 6 of the 54 patients with a nuclear positivity lower than 20% developed a laterocervical metastasis (P=0.001). When comparing survival curves of Skp≥20% and Skp2. Over- expression of MET receptor is correlated to nodal metasta- ses in all cases studied. Conclusions: The prognostic value of many parameters is widely recognized. The combined evaluation of ‘composite factors’ is promising. There is an important correlation between a Skp2 expres- sion lower than 20% and the capability of the tumour not to develop nodal metastases (p=0.001). Mutated MET can undergo clonal expansion during me- tastatic spread of human head and neck squamous cell carcinoma, suggesting that this gene might play an impor- tant role in the progression from primary cancer to metastasis.
CLINICOPATHOLOGICAL PARAMETERS AND OUTCOME OF 500 PATIENTS OPERATED FOR ORAL SQUAMOUS CELL CARCINOMA AND STUDY OF SEVERAL BIOMARKERS IN THE DEVELOPMENT OF NODAL METASTASES
Paolo Garzino Demo;Paolo Tosco;Emanuele Zavattero;Giulia Tanteri;Francesca Antonella Bianchi;Guglielmo Ramieri;Sid Berrone
2012-01-01
Abstract
Introduction: The outcome of 500 patients undergoing surgery for oral squamous cell carcinoma (OSCC) was evaluated in order to identify the prognostic value of several factors. Risk factors, tissue and biological markers (MET proto-oncogene, S phase kinase-associated protein-Skp2) have also been taken into consideration as possible indicators of tumour aggressiveness and predictors of the carcinogenic process and metastatic capability. Methods: A total of 500 patients were studied who had undergone surgery for OSCC between 1989 and 2011. For each patient, personal data, alcohol and tobacco con- sumption, symptoms, histological findings, treatment and outcome were recorded and analyzed statistically. Survival curves were calculated using the Kaplan–Meier algorithm, and the difference in survival among subgroups was examined. The role of S phase kinase-associated protein (Skp2) and of MET gene mutations was investigated in 71 and 12 patients respectively. Results : The differences in the 5-year survival were sig- nificant for the site of origin, N and pN status, TNM stage groups, grading, status of the resection margins, osseous infiltration, and perineural invasion. Vascular involvement was not statistically significant. In patients undergoing radiation therapy, only perineural invasion negatively influenced the 5-year survival prognosis. Nine of the seventeen patients with Skp2 positive nuclei (≥20%) developed nodal metastasis. Conversely, only 6 of the 54 patients with a nuclear positivity lower than 20% developed a laterocervical metastasis (P=0.001). When comparing survival curves of Skp≥20% and Skp2. Over- expression of MET receptor is correlated to nodal metasta- ses in all cases studied. Conclusions: The prognostic value of many parameters is widely recognized. The combined evaluation of ‘composite factors’ is promising. There is an important correlation between a Skp2 expres- sion lower than 20% and the capability of the tumour not to develop nodal metastases (p=0.001). Mutated MET can undergo clonal expansion during me- tastatic spread of human head and neck squamous cell carcinoma, suggesting that this gene might play an impor- tant role in the progression from primary cancer to metastasis.
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