Clues toward precision medicine in oral squamous cell carcinoma: utility of next-generation sequencing for the prognostic stratification of high-risk patients harboring neck lymph node extracapsular extension

被引:8
作者
Wang, Hung-Ming [1 ,2 ]
Liao, Chun-Ta [2 ,3 ]
Yen, Tzu-Chen [2 ,4 ,5 ]
Chen, Shu-Jen [6 ]
Lee, Li-Yu [2 ,7 ]
Hsieh, Chia-Hsun [1 ,2 ]
Lin, Chien-Yu [2 ,8 ]
Ng, Shu-Hang [2 ,9 ]
机构
[1] Chang Gung Mem Hosp, Div Med Oncol, Dept Internal Med, Taoyuan, Taiwan
[2] Chang Gung Univ, Taoyuan, Taiwan
[3] Chang Gung Mem Hosp, Dept Otorhinolaryngol, Sect Head & Neck Surg, Taoyuan, Taiwan
[4] Chang Gung Mem Hosp, Dept Nucl Med, Taoyuan, Taiwan
[5] Chang Gung Mem Hosp, Mol Imaging Ctr, Taoyuan, Taiwan
[6] ACT Genom, Taipei, Taiwan
[7] Chang Gung Mem Hosp, Dept Pathol, Taoyuan, Taiwan
[8] Chang Gung Mem Hosp, Dept Radiat Oncol, Taoyuan, Taiwan
[9] Chang Gung Mem Hosp, Dept Diagnost Radiol, Taoyuan, Taiwan
关键词
next-generation sequencing; precision medicine; oral squamous cell carcinoma; extracapsular extension; TP53 DNA-binding domain; EVOLUTIONARY ACTION SCORE; LOCALLY ADVANCED HEAD; DISTANT METASTASES; RADIATION-THERAPY; TREATMENT FAILURE; SPREAD; CANCER; CHEMOTHERAPY; RADIOTHERAPY; CHEMORADIOTHERAPY;
D O I
10.18632/oncotarget.11762
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Patients with resected oral squamous cell carcinoma (OSCC) harboring extracapsular extension (ECE) of the involved lymph node, show poor and heterogeneous outcomes. We aim to improve their prognostic stratification by combining genetic information from next-generation sequencing (NGS) using traditional clinicopathological prognosticators. The hotspot mutation regions of 45 cancer-related genes were investigated using NGS with an ultra-deep (>1000x) sequencing approach in formalin-fixed paraffin-embedded samples obtained from 201 patients with resected OSCC harboring ECE. Adjuvant chemoradiotherapy (CRT) and the number of nodes with ECE were the most important traditional prognosticators for disease-specific survival (DSS). The 5-year DSS for patients with CRT versus without, was 55% versus 21% (P < 0.001), and that for 1-3 versus >= 4 ECEs was 60% versus 25% (P = 0.001), respectively. Multivariate analysis in patients who received adjuvant CRT for 1-3 ECEs (i.e., those with a favorable expected prognosis) identified the following adverse prognostic factors: 1) margin of < 5 mm for locoregional failure (66% versus 30%, P = 0.007) and DSS (42% versus 63%, P = 0.039); 2) HRAS mutation for distant failure (55% versus 25%, P = 0.007) and DSS (36% versus 63%, P = 0.024); and 3) TP53 DNA-binding domain missense mutations for DSS (52% versus 71%, P = 0.025) and overall survival (39% versus 61%, P = 0.007). We conclude that genetic information from NGS may improve the prognostic stratification offered by traditional prognosticators in resected OSCC patients with ECE. Our findings will contribute to implementation of precision medicine in OSCC patients.
引用
收藏
页码:63082 / 63092
页数:11
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