Prognostic significance of hypoxia-inducible factor-1α expression in advanced pharyngeal cancer without human papillomavirus infection

Objective This study aimed to clarify the association between both hypoxia-inducible factor-1 alpha and glucose transporter type-1 expression and survival outcome in advanced pharyngeal cancer without human papillomavirus infection. Method Twenty-five oropharyngeal and 55 hypopharyngeal cancer patients without human papillomavirus infection were enrolled. All patients had stage III-IV lesions and underwent concurrent chemoradiotherapy or surgery. Hypoxia-inducible factor-1 alpha and glucose transporter type-1 expression were investigated in primary lesions by immunohistochemistry. Results There were 41 and 39 cases with low and high hypoxia-inducible factor-1 alpha expression, and 28 and 52 cases with low and high glucose transporter type-1 expression, respectively. There was no significant correlation between hypoxia-inducible factor-1 alpha and glucose transporter type-1 expression. In univariate analysis, nodal metastasis, clinical stage and high hypoxia-inducible factor-1 alpha expression, but not glucose transporter type-1 expression, predicted significantly worse prognosis. In multivariate analysis, hypoxia-inducible factor-1 alpha overexpression was significantly correlated with poor overall survival, disease-specific survival and recurrence-free survival. Conclusion High hypoxia-inducible factor-1 alpha expression was an independent risk factor for poor prognosis for advanced human papillomavirus-unrelated pharyngeal cancer.