High perioperative level of oxidative stress as a prognostic tool for identifying patients with a high risk of recurrence of head and neck squamous cell carcinoma

• Published in: International journal of clinical oncology 2010-12, Vol.15 (6), p.565-570
• Main Authors: Salzman, Richard, Pácal, Lukáš, Kaňková, Kateřina, Tomandl, Josef, Horáková, Zuzana, Tóthová, Eva, Kostřica, Rom
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cancer Research; Carcinoma, Squamous Cell - metabolism; Carcinoma, Squamous Cell - pathology; Cells; Cohort Studies; Female; Follow-Up Studies; Glutathione Peroxidase - metabolism; Head & neck cancer; Head and Neck Neoplasms - metabolism; Head and Neck Neoplasms - pathology; Humans; Male; Malondialdehyde - metabolism; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - metabolism; Neoplasm Staging; Oncology; Original Article; Oxidative Stress; Prognosis; Prospective Studies; Risk Factors; Surgical Oncology; Survival Rate
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-010-0108-z

Background The aim of the study was to investigate the relationships among (a) glutathione peroxidase (GPx) and malondialdehyde (MDA); (b) oncological characteristics (i.e., TNM classification, tumor grade), and; (c) prognosis of head and neck squamous cell carcinoma. Methods In a prospective cohort study, we followed 88 patients for 67.4 months (median 40.3) after surgery for head and neck squamous cell carcinoma. Activity of GPx was determined by ELISA and plasma MDA concentration by liquid chromatography. Results Lower GPx activity was observed in the T3/4 patients than in the T1/2 group. Tumor grade was significantly correlated with both GPx ( P  = 0.001) and MDA ( P  = 0.05, both Spearman). The perioperative level of MDA was higher in patients who later recurred during the follow-up period ( n  = 15) than in the complete remission group ( P  = 0.01, Mann–Whitney). Median disease-free interval and overall survival in the group with MDA > median were 29.5 and 32.0 months, respectively, and 38.4 and 40.3 months in the patient group with MDA ≤ median ( P  = 0.10 and P  = 0.08, respectively; Kaplan–Meier). Patients with MDA levels higher than the median had a more than twofold greater risk of recurrence than patients with MDA levels smaller than the median (31.3 vs. 15.2%, P  = 0.06, logrank). Conclusion Our results suggest that an increased MDA level at the time of initial surgery is found in patients with a high risk of recurrence, which suggests that each patient can be categorized according to risk of recurrence based on their MDA level at the time of initial surgery.