Cyclooxygenase-2 expression in squamous cell carcinoma of larynx: association with clinico-pathological factors and treatment outcomes


  • Elizabeth Mathew Iype Department of Surgical Oncology, Regional Cancer Centre, Thiruvanathapuram, Kerala, India
  • Rajan Balakrishna Department of Radiation Oncology, Regional Cancer Centre, Thiruvanathapuram, Kerala, India
  • Lakshmi Subhadradevi Division of Cancer Research, Regional Cancer Centre, Thiruvanathapuram, Kerala, India
  • Jissa Vinoda Thulaseedharan Sreechitra Thirunal Institute of Medical Science and Technology, Thiruvanathapuram, Kerala, India
  • Rajesh Singh Department of Surgical Oncology, Regional Cancer Centre, Thiruvanathapuram, Kerala, India
  • Jayasree K. Department of Pathology, Regional Cancer Centre, Thiruvanathapuram, Kerala, India



Cyclooxygenase 2, Larynx, Predictive marker, Reverse transcriptase polymerase chain reaction, Squamous cell carcinoma


Background: Squamous cell carcinoma (SCC) of larynx is widely prevalent in India and is one of the leading cancers in males. Tumor Cyclooxygenase-2 (Cox-2) expression can be used as a prognostic and predictive marker in laryngeal SCC. The primary objective of the present study was to determine the association between tumor Cox-2 expression and clinico-pathological characteristics and treatment outcome in patients with LSCC. Secondly, to evaluate the clinical utility of Cox-2 expression as a tool, to decide treatment strategy for LSCC.

Methods: Seventy two patients with stage III and IV LSCC who underwent upfront surgery were included in this study. Tumor Cox-2 expression was analysed by immunohistochemistry using standard Streptavidin biotin method.  

Results: Thirty seven patients had pathological node involvement, ipsilateral in 35 and bilateral in two. Cox-2 was intensely expressed in patients with advanced (N2/N3) nodal disease and perineural invasion. There was no significant difference in 5 year disease free survival and overall survival when Cox-2 was correlated with perineural invasion, extra capsular spread and the T and N stage of the disease.

Conclusions: Preoperative Cox-2 analysis can be used to individualize need for routine neck dissection in cases of locally advanced laryngeal carcinoma.


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