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Association With Poor Prognosis

Scott D. Meredith, MD; Paul A. Levine, MD; James A. Burns, MD; Michael J. Gaffey, MD; James C. Boyd, MD; Lawrence M. Weiss, MD; Nicholette L. Erickson, MD; Michael E. Williams, MD

Arch Otolaryngol Head Neck Surg. 1995;121(7):790-794.

Abstract
Objective
To determine the clinical and prognostic significance of chromosome 11q13 amplification in squamous cell carcinoma of the head and neck.

Design
Retrospective clinical analysis.

Setting
University and private cancer centers.

Patients
Fifty-six patients with pathologically confirmed head and neck squamous cell carcinoma whose tumors had been assayed for the presence or absence of chromosome 11q13 amplification.

Measurements
The degree of DNA amplification in each tumor was determined using chromosome 11q13 probes for the bcl-1 major translocation cluster, PRAD1/cyclin D1 (CCND1), the fibroblast growth factor gene HST1, EMS1, and glutathione-S-transferase-pi-1. The presence or absence of amplification in each patient was correlated with primary site, tumor stage, nodal status, presence or absence of distant metastasis, disease recurrence, time to recurrence, clinical outcome (disease status), and overall survival.

Results
Amplification of chromosome 11q13 was identified in 39% (22/56) of patients. Recurrent or persistent disease was identified in 82% (18/22) of cases with amplification and 50% (14/28) of nonamplified cases (P=.04). Mean time to recurrence was shorter in cases with amplification (6.2 months) than those without amplification (10.1 months) (P=.01). Eighteen patients (82%) with amplification and 10 patients (38%) without amplification died of disease or are alive with disease (P=.001). The mean follow-up period was 15.8 months for patients with amplification and 18.6 months for patients without amplification. Overall survival was significantly diminished in patients with amplification (P=.002). Amplification was not related to nodal status, distant metastases, or initial disease stage.

Conclusions
Amplification of chromosome 11q13 loci may be an important biologic marker indicating poor prognosis, independent of clinical stage in head and neck squamous cell carcinoma, and it should be assessed in prospective trials to determine its utility for stratifying treatment and determining prognosis.

(Arch Otolaryngol Head Neck Surg. 1995;121:790-794)

Author Affiliations
From the Departments of Otolaryngology—Head and Neck Surgery (Drs Meredith, Levine, and Burns), Internal Medicine, Division of Hematology/Oncology (Drs Erickson and Williams), and Pathology (Drs Gaffey and Boyd), University of Virginia Health Sciences Center, Charlottesville; and the Department of Pathology, City of Hope National Medical Center, Duarte, Calif (Dr Weiss).

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