This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (23)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Head & Neck Cancer  • Laryngology/ Speech/ Language Pathology  • Neoplasms of Head & Neck  • Surgical Oncology  • Alert me on articles by topic

Scott Franklin, MD; Thuy Pho; Fleurette W. Abreo, MD; Raja Nassar, PhD; Arrigo De Benedetti, PhD; Fred J. Stucker, MD; Cherie-Ann O. Nathan, MD

Arch Otolaryngol Head Neck Surg. 1999;125:177-182.

Background  The proto-oncogene eIF4E has been found to be elevated in head and neck squamous cell carcinomas. In an earlier prospective study overexpression of eIF4E, detected by Western blot analysis, in histologically normal surgical margins correlated with an increased local-regional recurrence rate during a 1-year follow-up.

Objective  To test the reverse hypothesis that absence of overexpression of eIF4E in the surgical margins is a predictor for long-term survival in patients with squamous cell carcinoma of the head and neck.

Design  A retrospective analysis was performed on 31 patients who underwent surgery for squamous cell carcinoma of the larynx or hypopharynx. Immunohistochemical analysis was used to detect eIF4E on paraffin-embedded sections of the tumor and the histologically negative surgical margins.

Results  All 31 patients overexpressed eIF4E in the tumors. Thirteen patients had no detectable level of eIF4E in the margins, and only 1 had a local-regional recurrence. The average disease-free interval in this group of patients was 82.08 months. The remaining 18 patients all overexpressed eIF4E in the surgical margins (eIF4E score range, 5-80). Twelve (67%) of these patients developed a recurrence; the average disease-free interval was 31.95 months. Cox regression analysis showed that eIF4E in the margin (P=.01), nodes (P=.06), site (P=.02), and age (P=.02) had significant effects on the disease-free interval. The Kaplan-Meier survival curves were significantly different for eIF4E-positive and eIF4E-negative margins (P=.002).

Conclusions  eIF4E in the surgical margins is an independent prognostic factor and its absence in surgical margins may predict long-term survival. Detecting eIF4E in the margins may improve survival by determining which patients would benefit from further resection or adjuvant therapy.

From the Department of Otolaryngology–Head and Neck Surgery, Louisiana State University Medical Center and Veterans Administration Medical Center, Shreveport (Drs Franklin, Stucker, and Nathan and Ms Pho); Department of Mathematics and Statistics, Louisiana Tech University, Ruston (Dr Nassar); and Departments of Pathology (Dr Abreo) and Biochemistry/Molecular Biology (Dr De Benedetti), Louisiana State University Medical Center.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The antiviral drug ribavirin does not mimic the 7-methylguanosine moiety of the mRNA cap structure in vitro
WESTMAN et al.
RNA 2005;11:1505-1513.
ABSTRACT | FULL TEXT  

Overexpressed eIF4E Is Functionally Active in Surgical Margins of Head and Neck Cancer Patients via Activation of the Akt/Mammalian Target of Rapamycin Pathway
Nathan et al.
Clin. Cancer Res. 2004;10:5820-5827.
ABSTRACT | FULL TEXT  

Best Practice No 169: Evidence based pathology: squamous carcinoma of the hypopharynx
Helliwell
J. Clin. Pathol. 2003;56:81-85.
ABSTRACT | FULL TEXT