Prognostic significance of hypoxia-inducible factor-1α expression in advanced pharyngeal cancer without human papillomavirus infection.

S Agena,S Kondo,N Hasegawa,H Hirakawa,N Kise,Y Yamashita,A Ganaha,H Kinjyo,J Uezato,H Maeda,A Kiyuna,M Suzuki,T Ikegami

doi:10.1017/s0022215121001468

Abstract

This study aimed to clarify the association between both hypoxia-inducible factor-1α and glucose transporter type-1 expression and survival outcome in advanced pharyngeal cancer without human papillomavirus infection. Twenty-five oropharyngeal and 55 hypopharyngeal cancer patients without human papillomavirus infection were enrolled. All patients had stage III-IV lesions and underwent concurrent chemoradiotherapy or surgery. Hypoxia-inducible factor-1α and glucose transporter type-1 expression were investigated in primary lesions by immunohistochemistry. There were 41 and 39 cases with low and high hypoxia-inducible factor-1α expression, and 28 and 52 cases with low and high glucose transporter type-1 expression, respectively. There was no significant correlation between hypoxia-inducible factor-1α and glucose transporter type-1 expression. In univariate analysis, nodal metastasis, clinical stage and high hypoxia-inducible factor-1α expression, but not glucose transporter type-1 expression, predicted significantly worse prognosis. In multivariate analysis, hypoxia-inducible factor-1α overexpression was significantly correlated with poor overall survival, disease-specific survival and recurrence-free survival. High hypoxia-inducible factor-1α expression was an independent risk factor for poor prognosis for advanced human papillomavirus-unrelated pharyngeal cancer.

Highlights

The head and neck regions are closely associated with quality of life and social activity, so their functional preservation is important in the treatment of head and neck cancer as well as for fair prognosis
Concurrent chemoradiotherapy has been successfully introduced for the treatment of head and neck cancer.[1,2]
Surgical treatment after concurrent chemoradiotherapy can cause a number of complications, such as local infection and suture breakage because of scarring and decreased local blood flow.[6,7,8,9]

Summary

Introduction

The head and neck regions are closely associated with quality of life and social activity, so their functional preservation is important in the treatment of head and neck cancer as well as for fair prognosis. Concurrent chemoradiotherapy has been successfully introduced for the treatment of head and neck cancer.[1,2] patients sometimes have severe early and late adverse toxic reactions such as mucositis, disturbance of salivary secretion, dysphagia, laryngeal necrosis and mandibular osteomyelitis.[3,4,5] These adverse events decrease the treatment completion rate and increase the mortality rate. Salvage surgery is used to control tumours after concurrent chemoradiotherapy failure. Surgical treatment after concurrent chemoradiotherapy can cause a number of complications, such as local infection and suture breakage because of scarring and decreased local blood flow.[6,7,8,9] biomarkers for predicting the effects of concurrent chemoradiotherapy have been examined

Methods

Results

Discussion

Conclusion