Prognosis Of Laryngeal Cancer Research Articles

Exploration and validation of the effects of robust co-expressed immune-related genes on immune infiltration patterns and prognosis in laryngeal cancer

ObjectivesLaryngeal cancer is a common malignant tumor that originates from the larynx, yet its molecular mechanisms have not been thoroughly explored. The purpose of this study was to identify and evaluate immune-related genes in laryngeal cancer through gene co-expression networks, which may serve as biomarkers for its immunotherapy. MethodsWe applied ESTIMATE to evaluate the immune-infiltration landscape of tumor microenvironment. The co-expression networks were constructed by weighted gene co expression network analysis (WGCNA) and compared with the existing human immune related genes (IRGs) to determine the co-expressed IRGs. GSVA combined with CIBERSORT and ssGSEA illustrated the correlation of hub genes and immune infiltration patterns. TIDE algorithm and Subclass mapping evaluated the function of hub genes in predicting immune function and immunotherapeutic sensitivity. The pRRophetic was employed in the sensitivity prediction of chemotherapeutic drugs. ResultsA total of 23 co-expressed IRGs were identified and showed robust expression characteristics. These genes were significantly related to immune infiltration patterns, immune function and sensitivity prediction of immunotherapy and chemotherapeutic drugs for laryngeal cancer patients. Genetic alteration in somatic mutation level and related pathways were also revealed. ConclusionThe 23 co-expressed IRGs may act as immunotherapeutic biomarkers and potential therapeutic targets for laryngeal cancer with certain expression robustness. The molecular mechanisms deserve further investigation, which will guide clinical treatment in the future.

Involvement of the Anterior Commissure in Early Glottic Cancer (Tis-T2): A Review of the Literature.

Background: The impact of the anterior commissure (AC) involvement on prognosis in laryngeal cancer remains a topic of discussion with inconsistent results in the literature. This review examines AC involvement as a prognostic factor in patients with early glottic cancer (Tis–T2) treated with radiotherapy or transoral laser microsurgery (TLM). Methods: A systematic literature search was performed. Due to the heterogeneity of the data, no meta-analysis was implemented. Weighted averages were calculated if the appropriate data were extractable. Results: Thirty-four studies on radiotherapy and 23 on TLM fit the inclusion criteria. The majority of studies for both radiotherapy (67.7%) and TLM (75.0%) did not report a significant impact on oncological outcomes. Weighted averages were slightly lower in patients with AC involvement. The two studies that applied a more detailed classification showed a significant impact on the amount of AC involvement. Conclusions: Binary variables (yes/no) for AC involvement lead to inconsistent results. Studies that use more detailed classifications of the AC show that there is a significant impact on the outcome. To further elucidate the role of the AC, detailed stratification of tumors involving the AC need to be investigated in further studies for both treatment modalities.

Identification and potential mechanisms of a 4-lncRNA signature that predicts prognosis in patients with laryngeal cancer

PurposeThis study aimed to describe the use of a novel 4-lncRNA signature to predict prognosis in patients with laryngeal cancer and to explore its possible mechanisms.MethodsWe identified lncRNAs that were differentially expressed between 111 tumor tissue samples and 12 matched normal tissue samples from The Cancer Genome Atlas Database (TCGA). We used Cox regression analysis to identify lncRNAs that were correlated with prognosis. A 4-lncRNA signature was developed to predict the prognosis of patients with laryngeal cancer. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to verify the validity of this Cox regression model, and an independent prognosis analysis was used to confirm that the 4-lncRNA signature was an independent prognostic factor. Furthermore, the function of these lncRNAs was inferred using related gene prediction and Gene ontology (GO) enrichment analysis in order to clarify the possible mechanisms underlying their predictive ability.ResultsIn total, 214 differentially expressed lncRNAs were identified, and a 4-lncRNA signature was constructed using Cox survival analysis. The risk coefficients in the multivariate Cox analysis revealed that LINC02154 and MNX1-AS1 are risk factors for laryngeal cancer, whereas MYHAS and LINC01281 appear to be protective factors. The results of a functional annotation analysis suggested that the mechanisms by which these lncRNAs influence prognosis in laryngeal cancer may involve the extracellular exosome, the Notch signaling pathway, voltage-gated calcium channels, and the Wnt signaling pathway.ConclusionWe identified a novel 4-lncRNA signature that can predict the prognosis of patients with laryngeal cancer and that may influence the prognosis of laryngeal cancer by regulating immunity, tumor apoptosis, metastasis, invasion, and other characteristics through the Notch signaling pathway, voltage-gated calcium channels, and the Wnt signaling pathway.

Expression of protein disulfide isomeraseA3 and its clinicopathological association in gastric cancer.

Protein disulfide isomerase A3 (PDIA3) is a chaperone protein that supports the folding and processing of synthesized proteins. Its expression is associated with the prognosis of laryngeal cancer, hepatocellular carcinoma, diffuse glioma and uterine cervical cancer. In the present study, the expression levels of PDIA3 and its clinicopathological association were examined in 52 cases of gastric cancer (GC). The expression of PDIA3 was examined by immunohistochemistry and scored using a semi-quantitative method. According to the score, GC samples were classified into PDIA3‑High and PDIA3‑Low GC. PDIA3‑High GC samples were predominantly of the intestinal type. Multivariate survival analysis indicated that PDIA3 expression and cancer stage were independent factors. The overall survival of PDIA3‑High GC cases was significantly favorable compared with that of PDIA3‑Low GC cases, and this was more evident in cases at an advanced stage. In GC cell cultures, the PDIA3 and major histocompatibility complex (MHC) class I proteins were expressed in three out of the four assessed cell lines according to western blot analysis. Notably, the expression of MHC class I was increased by the stimulation of interferon γ. Co‑immunoprecipitation assays suggested the formation of a PDIA3 and MHC class I complex. The findings suggested that PDIA3 may be involved in the immune response of carcinoma cells. The improved prognosis in PDIA3‑High GC may be accounted for, in part, by sufficient antigen processing and expression of MHC class I, which can be mediated by PDIA3. It was suggested that PDIA3 serves an important role in the pathobiology of GC, and that PDIA3 is a useful marker for the prediction of prognosis.

Effect of HPV Infection on the Occurrence and Development of Laryngeal Cancer: A Review.

Laryngeal cancer has the second highest incidence of head and neck malignant tumors worldwide. In recent years, studies have shown that human papillomavirus (HPV) infection may be a high-risk factor for laryngeal cancer and closely related to the development and prognosis of laryngeal cancer. The mechanism of the occurrence and development of laryngeal cancer caused by HPV infection needs investigation, as does a rapid and effective HPV detection method for effectively preventing the occurrence of laryngeal cancer and controlling its development. Many studies have explored the relation between HPV infection and laryngeal cancer. Here we review the research progress in investigating HPV infection in terms of DNA, mRNA and protein levels in the occurrence and development of laryngeal cancer and routine HPV detection methods.

Srednji volumen trombocita kod karcinoma grkljana – uloga u određivanju stadija karcinoma

Aim: This study aimes to investigate alteration of MPV (mean platelet volume) in laryngeal cancer. The hypothesis is that different clinical stages of laryngeal cancer and histological characteristics may be the basis of the pathophysiological changes in size and number of platelets. Materials and methods: Laboratory and clinical data were analysed retrospectively from 76 patients with laryngeal squamous cell carcinoma. Two main groups were formed upon TNM clasification: early stage and advanced stage laryngeal cancer. Furthermore, the patients were subdivided according to cancer degree of differentiation and presence of blood vessel invasion. Results: Statisticly significant difference between early and advanced stage cancer in the demographic and smoking data was not found. The comparison of MPV values showed statistically significant difference (P=0,003) between early and advanced laryngeal cancer. Furthermore, platelet values were significantly higher in the advanced group (P <0,001). The patients with poor differentiated cancer had significantly lower MPV values (P=0,001) compared to the ones with well and moderate differentiated stage. The difference in platelet count in the same groups was not statistically significant (P=0,132). The MPV value was significantly lower (P <0,001) in the group with vascular invasion compared to the group without that cancer characteristic. Conclusion: Our results suggest the possibility of using MPV values to help the clinician in prognosis of laryngeal cancer. Determining MPV values and platelet count is easily accessible and inexpensive method that provides useful information in everyday clinical practice.

Fibroblast growth factor receptor 1 and 3 expression is associated with regulatory PI3K/AKT kinase activity, as well as invasion and prognosis, in human laryngeal cancer.

Aberrant fibroblast growth factor receptor (FGFR) expression is thought to contribute to the development of many types of cancer. As yet, however, their impact on the course and prognosis of head and neck cancer remains to be determined. Here, we aimed to investigate the effects of expression of the FGFR family members FGFR1 and FGFR3, as well as their downstream PI3K/AKT signal-regulated kinases, on the aggressiveness and prognosis of laryngeal cancer. In total 137 surgically removed squamous cell laryngeal cancer (SCLC) and 100 matched non-cancerous laryngeal mucosa (NCLM) samples were assessed for mRNA expression using quantitative real-time PCR. The corresponding proteins were analyzed by Western blotting. SLUG expression was assessed by immunohistochemistry. The expression data were subsequently related to tumor front grading (TFG), local/nodal recurrences, prognosis and overall survival. The FGFR1, FGFR3 and PI3K/AKT kinase mRNA and protein levels were found to be significantly higher in the SCLC than the NCLM samples (p < 0.05). A high FGFR1 mRNA/protein expression level was found to be associated with an increased invasion rate, according to TFG scale and SLUG level, a high local/nodal recurrence rate and a poor prognosis (p < 0.05). Similarly, we found that a high FGFR3 mRNA/protein expression level was associated with a shorter survival time (p < 0.05). In addition, we found that high PI3K/AKT kinase mRNA/protein levels were associated with a high TFG (p < 0.05). We also found that FGFR1/3 mRNA and FGFR1 protein levels were inversely associated with overall survival (log-rank test: FGFR1 mRNA p = 0.03, FGFR3 mRNA p = 0.04, FGFR1 protein p = 0.03). Subsequent multivariate analyses revealed that high FGFR3 mRNA expression may serve as an independent poor prognostic factor (HR 2.32, 95% CI 1.03-6.59; p = 0.04). We also found that the p-PI3K regulatory kinase protein level was significantly associated with survival in the cohort studied (HR 1.78, 95% CI 0.64-8.53; p = 0.03). From our data we conclude that FGFR1 and FGFR3, as well as its downstream regulatory PI3K/AKT kinases, may serve as potential biomarkers for the invasiveness and prognosis of laryngeal cancer. The expression of FGFR1/3-PI3K/AKT regulatory pathway members may be instrumental for the identification of patients at risk for an unfavorable clinical outcome.

Combined Effect of IL-12Rβ2 and IL-23R Expression on Prognosis of Patients with Laryngeal Cancer

Background/Aims: This study aimed to pathologically elucidate the roles of interleukin-12 receptor (IL-12R) β2 and interleukin-23 receptor (IL-23R) expression in tumor cells and tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment and to determine their combined effect on prognosis of laryngeal cancer (LC). Methods: The tumor-cell expression scores and TIL positivity ratiosof IL-12Rβ2 and IL-23R in matched LC and normal laryngeal tissue samples from 61 LC patients were measured via immunohistochemistry (IHC). We adopted a linear regression model to analyze the correlation between IL-12Rβ2 and IL-23R expression in tumor cells and TIL ratios. TheKaplan-Meier log-rank test and Cox regression hazard ratios were used to analyze survival. Results: LC tumor cells had a higher IL-12Rβ2 expression and TIL ratio than IL-23R expression and TIL ratio. The significant correlations between IL-12Rβ2 and IL-23R expression and TIL ratios were identified in LC tissues, particularly in well-differentiated LC. Furthermore, either high tumor cell IL-12Rβ2 or low IL-23R expression had better survival than its corresponding low or high expression, respectively. Similar results did for IL-12Rβ2 ratio and IL-23R ratio. Finally, patients with both high IL-12Rβ2 and low IL-23R had the best prognosis among any other combined groups with both gene expression (HR, 0.1; 95% CI, 0.0-0.8). Likewise, patients with positive ratios of high IL-12Rβ2 and low IL-23R TILs had the best survival (HR, 0.1; 95% CI, 0.0-0.4). Conclusion: IL-12Rβ2 and IL-23R create a homeostasis within the tumor cells and TILs, and this homeostasis affects prognosis. While the intrinsic mechanisms of epigenetic immunoediting for IL-12Rβ2 and IL-23R remain unknown, additional larger and functional studies are warranted for validation.

A link between RelB expression and tumor progression in laryngeal cancer.

Laryngeal cancer is a frequent malignancy originating from the squamous vocal epithelium in a multi-stage fashion in response to environmental carcinogens. Although most cases can be cured by surgery and/or radiotherapy, advanced and relapsing disease is common, and biomarkers of such dismal cases are urgently needed. The cancer genome of laryngeal cancers was recently shown to feature a signature of aberrant nuclear factor (NF)-κB activation, but this finding has not been clinically exploited. We analyzed primary tumor samples of 96 well-documented and longitudinally followed patients covering the whole spectrum of laryngeal neoplasia, including 21 patients with benign laryngeal diseases, 15 patients with dysplasia, 43 patients with early-stage carcinoma, and 17 patients with locally advanced carcinoma, for immunoreactivity of RelA, RelB, P50, and P52/P100, the main NF-κB subunits that activate transcription. Results were cross-examined with indices of tumor progression and survival. Interestingly, RelB expression increased with tumor stage, grade, and local extent. Moreover, patients displaying high RelB immunoreactivity exhibited statistically significantly poorer survival compared with patients featuring low levels of RelB expression (P = 0.018 by log-rank test). Using Cox regression analyses and tumor stage, local extent, grade and RelA/RelB immunoreactivity, we develop a new score that can independently predict survival of patients with laryngeal cancer. Hence we provide a simple and affordable NF-κB-based test to predict prognosis in laryngeal cancer.

Correlation between Survivin expression and laryngeal carcinoma: A meta-analysis.

In order to provide evidence for evidence-based medicine in the treatment and prognosis of laryngeal cancer in China, the meta-analysis electronically retrieved the case-control studies published in China about the Survivin expression and its association with clinical pathological features in the tissues of laryngeal carcinoma. The results showed that a total of 25 case-control studies were finally included with 1333 cases of laryngeal cancer and 528 cases of controls. The difference in the expression of Survivin between the two groups was statistically significant [OR=18.34, 95% CI (11.82, 28.47), P<0.00001]. The difference in the expression of Survivin between laryngeal carcinoma patients with lymph node metastasis or not was statistically significant [OR=0.25, 95% CI (0.17, 0.37), P<0.00001]. The expression of Survivin in clinical I-II stage group was significantly lower than in the clinical stage III-IV group [OR=0.24, 95% CI (0.18, 0.32), P<0.00001]. The expression of Survivin in patients with low/medium differentiation was significantly lower than that in those with high differentiation [OR=0.33, 95% CI (0.26, 0.43), P<0.00001]. The difference in the expression of Survivin among different T stages of laryngeal carcinoma was statistically significant [OR=0.35, 95% CI (0.21, 0.58), P<0.00001]. In conclusion, Survivin may play an important role in the occurrence and development of laryngeal carcinoma, and its high expression is related to the poor prognosis of patients with laryngeal cancer.

A high ratio of IL-12Rβ2-positive tumor-infiltrating lymphocytes indicates favorable prognosis in laryngeal cancer

BackgroundThe purpose of this study was to elucidate IL-12Rβ2’s roles as a tumor-associated immunological molecule, delineate the complex roles of IL-12Rβ2+ tumor-infiltrating lymphocytes (TILs) and tumor cell IL-12Rβ2 expression in the tumor microenvironment, and determine the correlation of IL-12Rβ2+ TILs and tumor cell IL-12Rβ2 expression with clinical prognosis. MethodsWe assessed mRNA and protein levels in matched laryngeal cancer tissues (LTs) and adjacent normal mucous membrane tissues (ANMMTs) from 3 laryngeal cancer (LC) patients and ratios of IL-12Rβ2+ TILs in matched LTs and ANMMTs from 61 LC patients. We used the Kaplan-Meier log-rank test and Cox regression hazard ratios to analyze survival. ResultsComparative proteomic and transcriptomic assays revealed that matched LTs and ANMMTs from the 3 patients had significantly different IL-12Rβ2 and IFN-γ expression; the ratio of IL-12Rβ2+ TILs decreased with lower degrees of tumor differentiation. Among all 61 LC patients, the IL-12Rβ2+ TIL ratio in ANMMTs (38.5% ± 22.8%) was significantly higher than that in LTs (29.7% ± 19%; p<.001). Kaplan-Meier analysis revealed that patients with an IL-12Rβ2+ TIL ratio ≥35% had significantly better survival than those with an IL-12Rβ2+ TIL ratio <35% (log rank p=0.041). Multivariable analysis showed a significant association between a high IL-12Rβ2+ TIL ratio and overall survival (hazard ratio, 0.14; 95% confidence interval, 0.03–0.77). ConclusionTumor cell differentiation is associated with TILs’ expression of IL-12Rβ2, and an IL-12Rβ2+ TIL ratio ≥35%) indicates favorable prognosis in LC.

Increased vascular endothelial growth factor expression predicts a worse prognosis for laryngeal cancer patients: a meta-analysis.

This study assessed the relationship between vascular endothelial growth factor expression and the laryngeal cancer prognosis. Systematic computerised searches of PubMed were performed up to 31 January 2015. Prognostic endpoints were overall survival and disease-free survival. The pooled hazard ratios for overall survival and disease-free survival were also calculated. Seven studies containing 975 patients were included. The pooled hazard ratio was 1.703 (95 per cent confidence interval, 1.373 to 2.112; z score = 4.85, p = 0.000) for overall survival and was 1.918 (95 per cent confidence interval, 1.410 to 2.609; z score = 4.15, p = 0.000) for disease-free survival. No significant publication bias was found. A sensitivity analysis showed that the results were robust. Power analyses also showed there was enough power to detect the calculated hazard ratios. The study found that vascular endothelial growth factor overexpression predicted a worse prognosis for laryngeal cancer patients. This supports a strategy of targeted therapy by blocking the vascular endothelial growth factor receptor.

Up-Regulation of Angiotensin-Converting Enzyme (ACE) Enhances Cell Proliferation and Predicts Poor Prognosis in Laryngeal Cancer.

BackgroundThe angiotensin-converting enzyme (ACE, CD143) gene plays a crucial role in the pathology of many cancers. Previous studies mostly focused on the gene polymorphism, but the other functions of ACE have rarely been reported. The purpose of this study was to investigate the expression of ACE and its biological function, as well as its prognostic value, in laryngeal cancer.Material/MethodsThe expression of ACE was detected by quantitative real-time polymerase chain reaction (qRT-PCR) analysis in 106 patients with laryngeal cancer and 85 healthy people. Then the cell proliferation was estimated after the cell lines Hep-2 were transfected with pGL3-ACE and empty vector, respectively. In addition, the relationship between ACE expression and clinicopathologic characteristics was analyzed. Finally, Kaplan-Meier analysis was used to evaluate the overall survival of patients with different ACE expression, while Cox regression analysis was conducted to reveal the prognostic value of ACE in laryngeal cancer.ResultsOur results demonstrate that ACE is over-expressed in laryngeal cancer and thus promotes cell proliferation. The up-regulation of ACE was significantly influenced by tumor stage and lymph node metastasis. Patients with high ACE expression had a shorter overall survival compared with those with low ACE expression according to Kaplan-Meier analysis. The ACE gene was also found to be an important factor in the prognosis of laryngeal cancer.ConclusionsOur study shows that the ACE gene was up-regulated, which promoted the cell proliferation, and it could be an independent prognostic marker in laryngeal cancer.

ADH1B and CDH1 polymorphisms predict prognosis in male patients with non-metastatic laryngeal cancer.

In this study, we assessed the association between single nucleotide polymorphisms (SNPs) in candidate genes and the prognosis of laryngeal cancer (LC) patients. Thirty-seven SNPs in 26 genes were genotyped in 170 male Han Chinese patients with LC. The effects of the candidate genes on the prognosis of LC patients were evaluated using Kaplan-Meier curves and Cox proportional hazards regression models. The GA genotype of rs1229984 (hazard ratio [HR], 0.537; 95% confidence interval [CI], 0.340–0.848; p = 0.008) in alcohol dehydrogenase 1B (ADH1B), and the AA genotype of rs9929218 (HR, 6.074; 95% CI, 1.426–25.870; p = 0.015) in CDH1 were associated with overall survival. Our data suggest that polymorphisms in ADH1B and CDH1 may be prognostic indicators in LC.

Gene and protein expression of glucose transporter 1 and glucose transporter 3 in human laryngeal cancer-the relationship with regulatory hypoxia-inducible factor-1α expression, tumor invasiveness, and patient prognosis.

Increased glucose uptake mediated by glucose transporters and reliance on glycolysis are common features of malignant cells. Hypoxia-inducible factor-1α supports the adaptation of hypoxic cells by inducing genes related to glucose metabolism. The contribution of glucose transporter (GLUT) and hypoxia-inducible factor-1α (HIF-1α) activity to tumor behavior and their prognostic value in head and neck cancers remains unclear. The aim of this study was to examine the predictive value of GLUT1, GLUT3, and HIF-1α messenger RNA (mRNA)/protein expression as markers of tumor aggressiveness and prognosis in laryngeal cancer. The level of hypoxia/metabolic marker genes was determined in 106 squamous cell laryngeal cancer (SCC) and 73 noncancerous matched mucosa (NCM) controls using quantitative real-time PCR. The related protein levels were analyzed by Western blot. Positive expression of SLC2A1, SLC2A3, and HIF-1α genes was noted in 83.9, 82.1, and 71.7 % of SCC specimens and in 34.4, 59.4, and 62.5 % of laryngeal cancer samples. Higher levels of mRNA/protein for GLUT1 and HIF-1α were noted in SCC compared to NCM (p < 0.05). SLC2A1 was found to have a positive relationship with grade, tumor front grading (TFG) score, and depth and mode of invasion (p < 0.05). SLC2A3 was related to grade and invasion type (p < 0.05). There were also relationships of HIF-1α with pTNM, TFG scale, invasion depth and mode, tumor recurrences, and overall survival (p < 0.05). In addition, more advanced tumors were found to be more likely to demonstrate positive expression of these proteins. In conclusion, the hypoxia/metabolic markers studied could be used as molecular markers of tumor invasiveness in laryngeal cancer.

Gene and protein expression of O-GlcNAc-cycling enzymes in human laryngeal cancer.

Aberrant protein O-GlcNAcylation may contribute to the development and malignant behavior of many cancers. This modification is controlled by O-linked β-N-acetylglucosamine transferase (OGT) and O-GlcNAcase (OGA). The aim of this study was to determine the expression of O-GlcNAc cycling enzymes mRNA/protein and to investigate their relationship with clinicopathological parameters in laryngeal cancer. The mRNA levels of OGT and MGEA5 genes were determined in 106 squamous cell laryngeal cancer (SCLC) cases and 73 non-cancerous adjacent laryngeal mucosa (NCLM) controls using quantitative real-time PCR. The level of OGT and OGA proteins was analyzed by Western blot. A positive expression of OGT and MGEA5 transcripts and OGT and OGA proteins was confirmed in 75.5 and 68.9 % and in 43.7 and 59.4 % samples of SCLC, respectively. Higher levels of mRNA/protein for both OGT and OGA as well as significant increases of 60 % in total protein O-GlcNAcylation levels were noted in SCLC compared with NCLM (p < 0.05). As a result, an increased level of OGT and MGEA5 mRNA was related to larger tumor size, nodal metastases, higher grade and tumor behavior according to TFG scale, as well as incidence of disease recurrence (p < 0.05). An inverse association between OGT and MGEA5 transcripts was determined with regard to prognosis (p < 0.05). In addition, the highest OGT and OGA protein levels were observed in poorly differentiated tumors (p < 0.05). No correlations with other parameters were noted, but the results showed a trend of more advanced tumors to be more frequently OGT and OGA positive. The results suggest that increased O-GlcNAcylation may have an effect on tumor aggressiveness and prognosis in laryngeal cancer.

Lymph Node Ratio for Postoperative Staging of Laryngeal Squamous Cell Carcinoma with Lymph Node Metastasis

BackgroundLymph node metastasis has a significant impact on laryngeal cancer prognosis. The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of laryngeal cancer was not reported.Patients and MethodsRecords of laryngeal cancer patients with lymph node involvement from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 1963) and Fudan University Shanghai Cancer Center (FDSCC, validating set, N = 27) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile.ResultsOptimal LNR cutoff points classified patients into three risk groups R1 (≤0.09), R2 (0.09–0.20) and R3 (>0.20), corresponding to 5-year cause-specific survival and overall survival in SEER patients of 55.1%, 40.2%, 28.8% and 43.1%, 31.5%, 21.8%, 2-year disease free survival and disease specific survival in FDSCC patients of 74.1%, 62.5%, 50.0%, and 67.7%, 43.2%, 25.0%, respectively. R3 stratified more high risk patients than N3 with the same survival rate, and R classification clearly separated N2 patients to 3 risk groups and N1 patients to 2 risk groups (R1–2 and R3).ConclusionsR classification is a significant prognostic factor of laryngeal cancer and should be used as a complementary staging system of N classification.

The importance of histological types for treatment and prognosis in laryngeal cancer

The importance of histological types for treatment and prognosis in laryngeal cancer

Prognostic Significance of Fhit and Wwox Proteins Expression in Laryngeal Cancer

Objective: The tumor suppressor genes, Fragile Histidine Triad (FHIT) and WW domain-containing oxidoreductase (WWOX) are encoded by fragile loci FRA3B and FRA16D at chromosomes 3p14.2 and 16q23.3. The expression of their protein products has been shown to decrease in several types of cancers. This concordant loss of expression suggests that these common fragile regions of the genome, where certain environmental and/or chemical factors result in damage, have important functions in carcinogenesis. The aim of this study was to determine the prognostic significance of the expression of the FHIT and WWOX genes in laryngeal cancer. Materials and methods: Sixty-two patients who underwent surgery for laryngeal cancer were investigated for this study. Factors taken into consideration are: age, gender, tumor stage, presence of lymph node metastasis, presence of distance metastasis, location of the tumor, tumor infiltration, length of clinical follow-up, length of remission period, the presence or absence of postoperative supplementary treatment, histopathologic differentiation of the tumor, volume of tumor, cartilage invasion, the presence of perineural invasion, and the condition of surgical resection margins have been detected. The obtained results were compared to the immune histochemistry findings. Results: Loss of FHIT expression was demonstrated in 39 (62.9%) patients and loss of WWOX expression was demonstrated in 29 (46.8%) patients. There were statistically significant differences between FHIT distributions of the T-stages (p:0.04). FHIT reduction was associated with tumor infiltration (p=0.05). It was also associated with lymph node metastasis (p=0.012). FHIT expression significantly decreased in patients with a history of smoking (p=0.006). There was a statistically significant difference between WWOX expression and the tumor stage (p:0.036), but WWOX expression was not associated with tumor infiltration, lymph node metastasis or smoking history. The other parameters, namely perineural invasion, surgery margins, cartilage involvement, postoperative therapy, disease-free survival, and the tumor’s location did not correlate with WWOX and FHIT expression. Conclusion: These results showed that the FHIT and WWOX genes may play a role in the prognosis of laryngeal cancer.

Selective vs Superselective Neck Dissection in Larynx Cancer

Objective: Since regional metastasis has a tremendous impact on the prognosis of laryngeal cancer, neck management is important. We reported the study regarding the necessity of level IV dissection in cN0 laryngeal carcinoma previously. Based on the previous study, we compared selective neck dissection II-III with SND II-IV in laryngeal cancer. Method: Thirty-six patients with cN0 laryngeal cancer were randomly assigned to receive SND II-III or SND II-IV for the elective neck dissection. The estimated blood loss and the rate of postoperative chyle leakage or phrenic nerve palsy were analyzed according to the different extent of neck dissections. Oncologic results were measured. Results: The mean age of patients was 63.4 years. Nineteen patients (52.8%) received SND II-III (group I) and 17 patients (47.2%) received SND II-IV (group II). No cases of chyle leakage or phrenic nerve paralysis were reported in both groups. Ten out of 36 patients (27.8%) had recurred. In group I, recurrence rate was 21.1% (4/19) and it was 35.3% (6/17) in group II. The 5-year recurrence-free survivals were 64.7% and 59.2% in group I and group II, respectively. The 5-year overall survivals for group I and group II were 93.3% and 86.9%, respectively. Conclusion: Although more cases should be accumulated for a definitive demonstration, we suggest that SND II-III is an appropriate modality in the neck management of cN0 laryngeal cancer in the aspects of perioperative morbidity and oncological safety compared with SND II-IV.