Elevated levels of urinary prostaglandin E metabolite indicate a poor prognosis in ever smoker head and neck squamous cell carcinoma patients Journal Article

   

Authors:	Kekatpure, V. D.; Boyle, J. O.; Zhou, X. K.; Duffield-Lillico, A. J.; Gross, N. D.; Lee, N. Y.; Subbaramaiah, K.; Morrow, J. D.; Milne, G.; Lippman, S. M.; Dannenberg, A. J.
Article Title:	Elevated levels of urinary prostaglandin E metabolite indicate a poor prognosis in ever smoker head and neck squamous cell carcinoma patients
Abstract:	Cyclooxygenase (COX)-derived prostaglandin E<sub>2</sub> (PGE<sub>2</sub>) plays a role in the development and progression of several tumor types including head and neck squamous cell carcinoma (HNSCC). Measurements of urinary PGE metabolite (PGE-M) can be used as an index of systemic PGE<sub>2</sub> production. In ever smokers, increased levels of urinary PGE-M reflect increased COX-2 activity. In this study, we determined whether baseline levels of urinary PGE-M were prognostic for ever smoker HNSCC patients. A retrospective chart review of ever smoker HNSCC patients treated with curative intent was done. Fifteen of 31 evaluable patients developed progressive disease (recurrence or a second primary tumor) after a median follow-up of 38 months. There were no statistically significant differences between patients with (n = 15) or without disease progression (n = 16) with regard to stage, site, treatment received, smoking status, and aspirin use during follow-up. Median urinary PGE-M levels were significantly higher in HNSCC patients with disease progression (21.7 ng/mg creatinine) compared with patients without (13.35 ng/mg creatinine; P = 0.03). Importantly, patients with high baseline levels of urinary PGE-M had a significantly greater risk of disease progression (hazard ratio, 4.76, 95% CI, 1.31-17.30; P &lt; 0.01) and death (hazard ratio, 9.54; 95% CI, 1.17-77.7; P = 0.01) than patients with low baseline levels of urinary PGE-M. These differences were most evident among patients with early-stage disease. Taken together, our findings suggest that high baseline levels of urinary PGE-M indicate a poor prognosis in HNSCC patients. Possibly, HNSCC patients with high COX-2 activity manifested by elevated urinary PGE-M will benefit from treatment with a COX-2 inhibitor. ©2009 American Association for Cancer Research.
Keywords:	adult; clinical article; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; disease course; squamous cell carcinoma; carcinoma, squamous cell; cancer patient; cancer staging; follow up; neoplasm staging; metabolism; tumor markers, biological; smoking; retrospective study; tumor marker; cancer mortality; high risk patient; chemistry; head and neck neoplasms; acetylsalicylic acid; cyclooxygenase 2 inhibitor; cyclooxygenase 2 inhibitors; cyclooxygenase 2; prostaglandin; prostaglandins; ptgs2 protein, human; urine; prostaglandin e; urine level; metabolite; head and neck tumor; 7 hydroxy 5,11 dioxotetranorprostane 1,16 dioic acid; 7-hydroxy-5,11-dioxotetranorprostane-1,16-dioic acid; drug use; head and neck carcinoma
Journal Title:	Cancer Prevention Research
Volume:	2
Issue:	11
ISSN:	1940-6207
Publisher:	American Association for Cancer Research
Date Published:	2009-11-01
Start Page:	957
End Page:	965
Language:	English
DOI:	10.1158/1940-6207.capr-09-0093
PUBMED:	19843689
PROVIDER:	scopus
PMCID:	PMC2784194
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-74049117079&partnerID=40&md5=5fb00578fafd5f606d4d9a6c0fc885fc
Notes:	--- - "Export Date: 30 November 2010" - "Source: Scopus"

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