Publication:

Cyclooxygenase-2 expression in squamous cell carcinoma of larynx: association with clinico-pathological factors and treatment outcomes

Background Squamous cell carcinoma (SCC) of larynx is widely prevalent in India and is one of the leading cancers in males. Tumor Cyclooxygenase-2 (Cox-2) expression can be used as a prognostic and predictive marker in laryngeal SCC. The primary objective of the present study was to determine the association between tumor Cox-2 expression and clinico-pathological characteristics and treatment outcome in patients with LSCC. Secondly, to evaluate the clinical utility of Cox-2 expression as a tool, to decide treatment strategy for LSCC.

Methods Seventy two patients with stage III and IV LSCC who underwent upfront surgery were included in this study. Tumor Cox-2 expression was analysed by immunohistochemistry using standard Streptavidin biotin method.

Results Thirty seven patients had pathological node involvement, ipsilateral in 35 and bilateral in two. Cox-2 was intensely expressed in patients with advanced (N2/N3) nodal disease and perineural invasion. There was no significant difference in 5 year disease free survival and overall survival when Cox-2 was correlated with perineural invasion, extra capsular spread and the T and N stage of the disease.

Conclusions Preoperative Cox-2 analysis can be used to individualize need for routine neck dissection in cases of locally advanced laryngeal carcinoma.