Dados do Trabalho

Título

Analysis of Biomarkers for Risk prediction of local recurrence in Oral cancer at single Cancer Center

Introdução

OSCC is the sixth most common cancer worldwide, characterized by heterogeneous cellular and histological features observed by different molecular parameters. The main biomarkers (BKs) associated with oral cavity tumorigenesis are p53, EGFR, Cyclin-D1, p16 and E-cadherin and their expression is associated with poor prognosis and multiples relapses, besides other histopathological prognostic factors associated to lower rates of overall (OS) and disease-free survival (DFS).

Objetivo

This study aims to confirm through histopathological assessment (HP) based on morphological tumor criteria and immunohistochemistry analysis (IHC) of the BKs the association with increased local recurrence in patients diagnosed with OSCC submitted to multimodal treatment at A.C. Camargo Cancer Center during 2013-2017.

Métodos

One hundred patients diagnosed with OSCC submitted to multimodal treatment were evaluated and distributed in two groups according to the primary local tumor: A) at the floor of the mouth and B) in the tongue, both groups treated with surgery exclusively, surgery plus radiotherapy (RT) and surgery with RT and chemotherapy. Immunohistochemistry (IHC) were performed for detection of these five BKs. Demographic and clinical data were collected, and the Chi-square statistical test was performed for determining association between them. Cox regression model was done, and the hazard ratio was established for each independent factor to predict clinical failure (p<=0.05).

Resultados

From 100 patients analyzed, 61% were male and 39% female. Regarding local primary tumor, 51% presented OSCC in the floor of the mouth and 49% in the tongue with a mean age of 62 years (R:29-86). The mean follow-up was 26 months (median: 28) and the mean of recurrence appearance was 12 months (median: 9). Most patients showed an initial stage (I-II) (63.6%), worst pattern of invasion (WPOI) 3-5 (70.5%), extracapsular extension (EE) (57.5%). Regarding BKs expression, 21.2% p16, 87.9% Cyclin-D1, 63% p53, 53.5% E-cadherin, and 66% EGFR. Statistical significance association between p53 expression and for both sex (p: 0.007) and smoking/alcohol consumption (p: 0.04) was observed. E-cadherin was associated with lymph node infiltration (p: 0.03). The median OS was 80% vs 60% in 03 years (p: 0.06); for DFS was 50% (p: 0.22) in 05 years. Cox regression showed that EGFR (HR: 4.97 / p: 0.016) and E-cadherin (HR:0.294/ p: 0.056) and EE as morphological tumor criteria (HR: 3.68 / p: 0.056) are independent factors for prediction of clinical failure.

Conclusões

EGFR and E-cadherin are potential biomarkers for prediction of OSCC recurrence, but further studies are still necessary to confirm this. In fact, these results must be validated in clinical practice through longitudinal studies such as randomized clinical trials.

Palavras-chave

Oral Squamous Cell Carcinomas; Biomarkers, tumor; EGFR-coamplified and overexpressed protein, human; cadherins; neoplasm recurrence, local; tumor suppressor protein p53.