Tumor markers in T1-T2 laryngeal squamous cell carcinoma: Considerations on a clinical and biological level

Early stage laryngeal cancer is predominantly treated with radiotherapy. However, in 40% of these patients the tumor does not respond or returns after a while. Often an extensive surgical procedure is the only remaining curative option, at a regular basis accompanied by wound complications, a long hospital admittance and even impaired survival. For that reason, lots of research is focused on tumor markers. Tumor markers are proteins in tumor cells with which potentially tumors that will not react well to radiotherapy can be identified. These tumors might need an alternative and more aggressive treatment.
Previously, research focusing on tumor markers in early-stage laryngeal cancer of the vocal cords (glottis) demonstrated a predictive value for the efficacy of radiotherapy in the case of, amongst others, HIF-1a, CA-IX, pFADD. Jan Edward Wachters evaluated the predictive value of these markers in a comparable group of patients with early stage laryngeal cancer, originated in the area just above the glottis, the supraglottis. He demonstrated that these tumor markers in this area did not show any predictive significance. On the other side, Wachters demonstrated that the expression of PTEN, a key protein involved in DNA-repair, did have predictive value in early stage cancer of the supraglottis.
It has been known that early-stage cancer of the glottis and supraglottis demonstrate clinical and epidemiological differences. Wachters has shown that these 2 types of tumor have molecular and tumor biological differences as well. These findings can have consequences for the interpretation of earlier reported results of tumor marker research and for the study designs, focusing on tumor markers, in the future.