ERCC1 expression as a predictive marker of squamous cell carcinoma of the head and neck treated with cisplatin-based concurrent chemoradiation

H J Jun, M J Ahn, H S Kim, S Y Yi, J Han, S K Lee, Y C Ahn, H-S Jeong, Y-I Son, J-H Baek, K Park, H J Jun, M J Ahn, H S Kim, S Y Yi, J Han, S K Lee, Y C Ahn, H-S Jeong, Y-I Son, J-H Baek, K Park

Abstract

The excision repair cross-complementation group 1 (ERCC1) enzyme plays a rate-limiting role in the nucleotide excision repair pathway and is associated with resistance to platinum-based chemotherapy. The purpose of this study was to evaluate the role of ERCC1 expression as a predictive marker of survival in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) treated with cisplatin-based concurrent chemoradiotherapy (CCRT). ERCC1 expression was assessed by immunohistochemical staining. The median age of the 45 patients analysed was 56 years (range 27-75 years), and 82% were men; 73% of all specimens showed high expression of ERCC1. The overall tumour response rate after CCRT was 89%. The median follow-up was 53.6 months (95% CI, 34.5-72.7 months). The 3-year progression-free survival (PFS) and overall survival (OS) rates were 58.7 and 61.3%, respectively. Univariate analyses showed that patients with low expression of ERCC1 had a significantly higher 3-year PFS (83.3 vs 49.4%, P=0.036) and OS (91.7 vs 45.5%, P=0.013) rates. Multivariate analysis showed that low expression of ERCC1 was an independent predictor for prolonged survival (HR, 0.120; 95% CI, 0.016-0.934, P=0.043). These results suggest that ERCC1 expression might be a useful predictive marker of locally advanced SCCHN in patients treated with cisplatin-based CCRT.

Figures

Figure 1
Figure 1
Representative examples of ERCC1 immunostains. (A) H score <2. (B) H score ⩾2. Original magnification, × 400.
Figure 2
Figure 2
Kaplan–Meier estimates of the probability of survival. (A) PFS according to ERCC1 expression. (B) OS according to ERCC1 expression.

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