Introduction Cancer stem cells (CSCs) are hold accountable for the progress of head and neck squamous
cell carcinoma (HNSCC). In the presented study, we evaluated the prognostic value
of CSC markers in two particular HNSCC cohorts.
Methods This two cohort study consisted of 85 patients with advanced stage HNSCC, treated
with primary radio(chemo)therapy (pRCT), and 95 patients with HNSCC, treated with
surgery and partially adjuvant radio(chemo)therapy. Overall survival (OS), disease
free survival (DFS), and disease specific survival (DSS) were assessed. Samples were
assessed for the expression of different molecular stem cell markers (ALDH1, BCL11B,
BMI-1, and CD44).
Conclusions In the pRCT cohort, none of the baseline patient and tumor features exhibited a statistically
significant relation with survival in both the cohort and HPV-stratified subcohorts.
High expression of BMI-1 significantly decreased OS and DFS, while high expression
of CD44 decreased all modes of survival. In the surgical cohort, classical prognosticators
such as HPV status, R1 resection, and nodal status in HPV negative HNSCC played a
significant role but the tested CSC markers showed no significant influences on prognosis.
Conclusion In patients with advanced or late stage HNSCC, testing for CSC markers and early
use of targeted therapies might be beneficial, especially if many comorbidities exist
or disease is inoperable.
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