Mammalian target of rapamycin expression and laryngeal squamous cell carcinoma prognosis: novel preliminary evidence.

AIMS: The mammalian target of rapamycin (mTOR) has a key role in regulating cancer cell proliferation, apoptosis, cell migration, and angiogenesis. The aim of this study was to assess the relationships between mTOR and clinicopathological and prognostic parameters in laryngeal squamous cell carcinoma (SCC). METHODS AND RESULTS: Mammalian target of rapamycin expression was determined in 103 consecutive operable laryngeal SCCs. Among the mTOR-positive cases, the locoregional recurrence rate was higher (P=0.048) and the disease-free survival (DFS) rate was shorter (P=0.031) in patients with mTOR expression >50.7%. In the N(0) subgroup, the disease recurrence rate was higher (P=0.034) and the DFS was shorter (P=0.009) in patients with mTOR expression >50.7%. In mTOR-positive patients, multivariate analysis showed that N stage (P=0.0001) and mTOR status (P=0.042) were independent indicators of a poor prognosis. CONCLUSIONS: mTOR appeared to be a significant predictor of DFS in univariate and multivariate models. mTOR expression in laryngeal SCC may be useful for the detection of patients at higher risk for recurrence, and N(0) patients at higher risk for early locoregional recurrence who might benefit from more aggressive therapy. The role of mTOR inhibitors in multimodality or multitarget strategies against laryngeal SCC warrants investigation.

A higher CD105-assessed microvessel density and worse prognosis in elderly patients with laryngeal carcinoma.

OBJECTIVES: To ascertain the prognostic role of endoglin (CD105)-assessed microvessel density (MVD) in patients older than 65 years with laryngeal squamous cell carcinoma (LSCC), and whether this MVD differed in the elderly patients from younger adult controls. DESIGN: Retrospective clinicopathologic investigation. SETTING: Academic tertiary referral center. PATIENTS: Fifty-seven consecutive elderly patients with LSCC and 19 younger adult controls. MAIN OUTCOME MEASURE: Image analysis of immunohistochemical reactions. RESULTS: In LSCCs in elderly patients, N+ stage correlated with a shorter disease-free survival (DFS) (P < .001). A higher CD105-assessed MVD was associated with disease recurrence (P = .006). The DFS was shorter in elderly patients whose CD105 expression was greater than 9.6% than in patients whose CD105 expression was 9.6% or less (P = .001). Among the elderly patients with tumors staged as N0, a higher CD105-assessed MVD correlated with disease recurrence (P = .006) and a shorter DFS (P = .001). CD105-assessed MVD in LSCC occurring in elderly patients did not differ from the situation observed in younger adult controls (P = .74). CONCLUSIONS: In LSCC occurring in elderly patients, CD105-assessed MVD may be a useful N-stage independent, angiogenic prognostic marker for pinpointing: (1) patients at higher risk of disease recurrence; and (2) patients with N0 tumors at higher risk of early recurrence, who may benefit from more aggressive therapy.