Variable Genetic Alterations and Survival in Head and Neck Cancer

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Abstract
THE DISCOVERY that specific genetic alterations are related to carcinogenesis has led to the search to find the genes that cause head and neck squamous cell carcinoma and the gene (or genes) that are markers of tumor aggressiveness. In colorectal cancer, it has been demonstrated that accumulated genetic changes underlie the development of neoplasia, and as this orderly loss of genes progresses, the cancer gains virulence.1 Comparative genomic hybridization, a technique that effectively scans the entire genome for aberrations, has shown that, in head and neck cancers, genetic losses and gains are present throughout the genome.2 At the University of Cincinnati, Cincinnati, Ohio, we have individually examined many tumor regulatory genes theorized to be related to tumor aggressiveness, including p53, retinoblastoma (RB), and cyclin D1, and found that loss of these individual genes does not correlate with survival.3-5 Genetic alterations at more than 1 locus, however, are associated with a poorer prognosis in head and neck cancer.3,6