Angiogenesis and CD34 Expression as a Predictor of Recurrence in Oral Squamous Cell Carcinoma

Kademani, Deepak; Lewis, Jason T.; Lamb, Derek H.; Rallis, David J.; Harrington, Jeffrey R.

doi:10.1016/j.joms.2008.06.081

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Volume 67, Issue 9 , Pages 1800-1805, September 2009

Angiogenesis and CD34 Expression as a Predictor of Recurrence in Oral Squamous Cell Carcinoma

Deepak Kademani, DMD, MD
- Formerly, Assistant Professor, Division of Oral Diagnosis and Oral and Maxillofacial Surgery; and Currently, Associate Professor, Oral and Maxillofacial Surgery, University of Minnesota Medical Center, Minneapolis, MN
- Address correspondence and reprint requests to Dr Kademani: Oral and Maxillofacial Surgery, University of Minnesota Medical Center, Moos Tower 7-1746, 515 Delaware St, Minneapolis, MN 55455
Jason T. Lewis, MD
- Formerly, Assistant Professor, Division of Surgical and Anatomic Pathology; and Currently, Private Practice, Chatanooga, TN
Derek H. Lamb, DMD, MD
- Resident, Division of Oral Diagnosis and Oral and Maxillofacial Surgery, Mayo Clinic, College of Medicine, Rochester, MN
David J. Rallis, DDS, MD
- Resident, Division of Oral Diagnosis and Oral and Maxillofacial Surgery, Mayo Clinic, College of Medicine, Rochester, MN
Jeffrey R. Harrington, BSc
- Biostatistician, Division of Biostatistics, Mayo Clinic, College of Medicine, Rochester, MN

Purpose

To assess immunohistologic features of angiogenesis of T1N0M0 oral squamous cell carcinoma (OSCC), and to identify predictors of regional recurrence. The identification of prognostic markers of early lymph node involvement in OSCC could allow for the use of more targeted biologic therapies for patients with early-stage tumors.

Patients and Methods

The study included patients treated for T1N0M0 OSCC at the Mayo Clinic from 1986 to 2001. All patients had initial surgical resection without neck dissection, and all had adequate follow-up with histologic specimens for review. Patients with lip, pharyngeal, or salivary gland tumors were excluded. Patient specimens were regraded and assessed for the histologic markers p53 and CD34 (penetrating and circumscribing patterns). The Kaplan-Meier method was used to estimate patient survival and survival free of regional recurrence.

Results

The study included 175 patients. The overall 5-year survival was 75%, and 5-year survival free of regional recurrence was 80.3%. Twenty-eight patients had regional recurrence. High-grade tumors (P = .03) and the penetrating pattern of CD34 (P = .02) were significantly associated with early regional metastasis from early-stage OSCC. The presence of p53 was not independently associated as a marker for regional metastasis.

Conclusion

Early-stage T1 OSCC with high-grade lesions and a penetrating pattern of CD34 was associated with a statistically significant risk of cervical lymph node metastasis, compared with a circumscribing pattern of CD34.