P53 gene mutations in surgical margins and primary tumor tissues of patients with squamous cell carcinoma of the head and neck

Abstract

Dear Editor, We read with interest this study by Tunca et al.1 about p53 gene mutations in surgical margins and primary tumor tissues of patients with squamous cell carcinoma of the head and neck. The authors concluded that there was no statistically significant association between the presence of p53 mutations in the primary tumor and the outcome of head and neck squamous cell carcinoma. In addition, they concluded that the presence of p53 mutations in the surgical margins may not increase the risk of local-regional recurrence1. Although no statistical significance was demonstrated in this study, the conclusions fail to take into account a number of important parameters. This study was conducted on heterogeneous tumor tissue specimens that contain functionally diverse groups of cells. The clinical relevance of this is not fully understood2 and hence the effect on the results is not known. DNA assays that perform well in laboratory dilutionsmay not be as reliable in clinical samples in which various contaminants, necrosis of the tumor, and degradation of DNAmay introduce significant confounders on the data3. Finally, the effects of the host immune response are not taken into account in the discussion.