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

Kekatpure VD, Boyle JO, Zhou XK, Duffield-Lillico AJ, Gross ND, Lee NY, Subbaramaiah K, Morrow JD, Milne G, Lippman SM, Dannenberg AJ
Cancer Prev Res (Phila). 2009 2 (11): 957-65

PMID: 19843689 · PMCID: PMC2784194 · DOI:10.1158/1940-6207.CAPR-09-0093

Cyclooxygenase (COX)-derived prostaglandin E(2) (PGE(2)) 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(2) 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 < 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.

MeSH Terms (17)

Aged Aged, 80 and over Biomarkers, Tumor Carcinoma, Squamous Cell Cyclooxygenase 2 Cyclooxygenase 2 Inhibitors Female Head and Neck Neoplasms Humans Male Middle Aged Neoplasm Staging Prognosis Prostaglandins Retrospective Studies Smoking Survival Rate

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