The relationship between expression of the inhibitor of apoptosis protein survivin and the presence of high-risk human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OSCC) remains unclear. This also accounts for its role as a predictor of survival. Therefore, we conducted a multicentre retrospective study on 106 consecutive oropharyngeal cancer patients. Human papillomavirus sequences were detected by nested PCR protocols. Survivin and p16 expression as a surrogate marker for HPV status were analysed by immunohistochemistry. Sequences of high-risk HPV were detected in 29% of cases. Prominent cytoplasmatic expression of survivin was found in 58% of cases and nuclear expression of survivin was found in 19% of the survivin-positive tumours. Nuclear expression of survivin was significantly correlated with HPV-negative tumours (P ¼ 0.023) and with a poor diseasefree survival rate with an estimated 3-year disease-free survival probability of 35% for tumours with nuclear expression of survivin vs 78% for tumours with non-nuclear expression of survivin (hazard ratio ¼ 8.264; 95% confidence interval (95% CI) ¼ 2.510 -27.210; Po0.001). In multivariate analysis, p16 expression status as well as nuclear expression of survivin were strong independent and opposing prognostic indicators of disease-free survival (hazard ratio ¼ 0.068; 95% CI ¼ 0.005 -0.892; P ¼ 0.041 and hazard ratio ¼ 15.975; 95% CI ¼ 2.377 -107.360; P ¼ 0.004, respectively). Our data show that nuclear accumulation of survivin correlates with HPV-independent carcinogenesis and is an independent predictor of poor survival in patients with OSCC.

Considering the strong impact of nuclear survivin expression on survival, the survivin expression should be prospectively evaluated to select patients with an increased risk for disease recurrence.

The correlation between cytoplasmic survivin expression and survival in salivary gland malignancies might make this an effective tool in patient follow-up, prognosis and targeted therapy in future.

Background: The expression of the inhibitor of apoptosis protein survivin is shown to be a significant prognostic indicator in various human cancers. Its role in cancer of the major salivary glands remains unclear. Methods: We analysed the survivin expression in 171 patients with malignant parotid gland cancer (12 different histological subtypes) by means of immunohistochemistry. The experimental findings were correlated with clinicopathological and survival parameters. The mean follow-up time was 42 months. Results: There was no significant correlation of cytoplasmic survivin expression levels with the patients’ clinicopathological characteristics. A strong cytoplasmic expression of survivin was found in 25% of the examined tumors. High cytoplasmic survivin expression was an independent prognostic indicator for a significant poorer 5-year disease-free survival rate (31% versus 67%, p<0.0005) and overall survival (45% versus 62%, p=0.048). In the multivariate analysis survivn expression and distant metastasis were significant predictors for patient outcome (p=0.001, p<0.0005). Conclusions: The correlation between cytoplasmic survivin expression and survival probabilities of salivary gland malignancies might make this an effective tool in patient follow-up, prognosis and targeted therapy in future. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1729.