Androgen receptor expression: Prognostic value in locally advanced squamous cell carcinoma of the head and neck

Background and purpose: This study investigated the prognostic value of androgen receptor (AR) expression of tumor cells in patients treated with surgery and subsequent radio(chemo)therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN). Material and methods: The impact of AR and 11 additional factors on locoregional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively studied in 163 patients with nonmetastatic stage III/IV SCCHN. Additional factors included age, gender, ECOG performance status, pre-radiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T category, N category, HPV status, extent of resection, and concurrent chemotherapy. Results: On multivariate analysis, improved LRC was significantly associated with pre-RT hemoglobin levels ≥ 12 g/dl (risk ratio [RR] 2.22; 95 % confidence interval [CI] 1.19-4.13; p = 0.013), tumor site (RR 1.39; 95 % CI 1.14-1.70; p = 0.001), lower T category (RR 1.67; 95 % CI 1.18-2.44; p = 0.003), and lower N category (RR 4.18; 95 % CI 1.90-10.55; p < 0.001). Improved MFS was associated with AR expression (RR 2.21; 95 % CI 1.01-5.41; p = 0.048), better ECOG performance status (RR 3.19; 95 % CI 1.50-7.14; p = 0.003), lower T category (RR 2.24; 95 % CI 1.47-3.65; p < 0.001), and lower N category (RR 5.33; 95 % CI 2.07-16.63; p < 0.001). OS was positively associated with AR expression (RR 1.99; 95 % CI 1.06-4.00; p = 0.032), better ECOG performance status (RR 2.20; 95 % CI 1.20-4.09; p = 0.010), pre-RT hemoglobin levels ≥ 12 g/dl (RR 2.13; 95 % CI 1.19-3.82; p = 0.012), lower T category (RR 1.81; 95 % CI 1.30-2.62; p < 0.001), and lower N category (RR 3.41; 95 % CI: 1.65-7.80; p < 0.001). Conclusion: Tumor cell expression of AR was an independent prognostic factor for MFS and OS and should be considered in future prospective trials.