p53 Immunostaining of Surgical Margins as a Predictor of Local Recurrence in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx

Abstract

Local and regional recurrence is the principal reason for treatment failure in squamous cell carcinoma (SCC) of the head and neck. The conventional method of evaluating surgical margins for cellular atypia does not always predict risk of local recurrence accurately. Immunostaining of surgical margins for tumor markers may provide a more precise evaluation of risk of local recurrence. Paraffin-embedded tissue blocks of surgical margins from 24 patients with oral cavity and oropharyngeal squamous cell carcinoma were immunostained for p53 protein. Fifty-eight percent of the patients had at least one margin stain positive for p53, including eight often patients whose SCC recurred locally. The sample odds ratio test predicted a 5.333 times higher chance of local recurrence with at least one p53 positive surgical margin. The implications of these results for patient management and further investigations will be discussed.

Prognostic significance of Survivin and CD44v6 in laryngeal cancer surgical margins

“…Hence, much attention has recently been focused on the evaluation of molecular pathologic prognostic factors. Previously, immunohistochemical studies have revealed that positive staining for markers of genomic alteration in histologically negative surgical margins are correlated with a high recurrence rate of cancers (Ball et al 1997;Smith et al 2000;Zhang et al 2008). To our knowledge, correlations between Survivin and CD44v6 expression in surgical margin and prognosis of laryngeal cancer have not been reported up to date.…”

p53, p63 and p73 expression and angiogenesis in keratocystic odontogenic tumors

“…Several studies demonstrate that p53 expression correlates with tumor grade and recurrence (23). Alterations in the p63 gene have been proposed as one of the factors responsible for tumorigenesis in oral cancer.…”

The role of molecular strategies in the evaluation of surgical margins in oropharyngeal squamous cell carcinoma

“…Mutation analysis of the P53 gene using a PCRsingle strand conformation polymorphism method in breast cancers has been shown to provide useful prognostic information [49]. Ball et al [50] and Cruz et al [51] demonstrated p53 immunoexpression in non-malignant oral mucosa of the resection margins and concluded that it may be a valuable predictor for local recurrences. In addition p53 gene mutations have been implicated as markers of tumour spread in synchronous oral cancers.…”