Prognostic value of cyclin D1 expression in tumor-free surgical margins in head and neck squamous cell carcinomas

Abstract

Conclusion. It was proved that cyclin D1-positive status in surgical margins was an independent prognostic indicator of local recurrence. The expression of cyclin D1 in tumor-free surgical margins may better predict local recurrence in head and neck squamous cell carcinoma (HNSCC) patients after surgical treatment with curative intent.Objectives. This retrospective study was aimed at determining the prognostic indicator for local recurrence in HNSCC.Method. A total of 116 HNSCC patients who underwent surgical treatment with curative intent and had histopathologically tumor-free margins were eligible for this study. The expression of p53 and cyclin D1 was assessed by the immunohistochemical staining in surgical margins as well as in tumor specimens.Results. Sixty-three patients (54.3%) had p53-positive tumor specimens, and 34 patients (29.3%) had p53-positive margins. Seventy-six patients (65.6%) had cyclin D1-positive tumor specimens, and 54 patients (46.6%) had cyclin D1-positive margins. A significant difference in local control rates was observed between patients with cyclin D1-positive and -negative margins (77.2% vs. 91.5%, log rank test, p=0.0139). Multivariate Cox proportional hazards testing indicated that the hazard ratio of cyclin D1-positive margins for local recurrence was 4.58 (95% confidence interval 1.14-21.69, p=0.0304).

Review of emerging biomarkers in head and neck squamous cell carcinoma in the era of immunotherapy and targeted therapy

“…In most studies, baseline biomarkers are evaluated for their prognostic role for disease outcomes (regardless of treatment), reflected by critical clinical trial endpoints. Key endpoints include overall survival (OS), progression‐free survival (PFS), disease‐free survival (DFS), loco‐regional (LR) control, and distant metastasis‐free survival …”

Surgical margins in head and neck squamous cell carcinoma: Effect of heat artifact on immunohistochemistry as a future tool for assessment

“…[61][62][63][64][65][66] Moving beyond this, our expanding understanding of the heterogeneity of an individual tumor, the importance of the invasive front/stromal interface, epithelial-mesenchymal transition, and cancer stem cells point to the need to be able to assess biological function, not just morphology, in assessment of HNSCC margins. 4,6,8,9,16,53,[67][68][69][70][71][72][73][74][75][76][77][78] Two major types of techniques have been proposed to assess biological margins in HNSCC by various authors: immunohistochemistry 4,14,16,48,51,54,55,79,80 and DNA extraction techniques. 4,9,11,13,16,78,79 Each technique has its advantages and disadvantages.…”

“…Increasingly, evidence in the literature demonstrates that this method of assessment does not reveal the full picture. 3,4,6,9,[11][12][13][14][15] Immunohistochemistry and various DNA techniques have both been shown by multiple authors to have potential. [8][9][10] This undetected change in biological nature may explain why positive margins are not always associated with local recurrence and a clear margin does not guarantee cure.…”

“…[2][3][4][5]7 This has led to an increasing interest in the use of biological and molecular markers in the assessment of surgical margins. 3,4,6,9,[11][12][13][14][15] Immunohistochemistry and various DNA techniques have both been shown by multiple authors to have potential. Protein biomarkers can be detected via immunohistochemistry, a technique that is relatively cheap, easy to perform, and widely available.…”

p53 & Cyclin D1 expression in surgically resected clear margins of oral squamous cell carcinoma

“…Head and Neck Squamous Cell Carcinoma (HNSCC) is a multistep process characterized by genetic and epigenetic alterations. These alterations in the tumour-free surgical margins that lead to recurrence may not be detected by conventional microscopic histological analysis but may be detected using immunohistochemical (IHC) staining 5,6 . TNM staging and histopathological grading are considered as the main prognostic factors in OSCC.…”