Association between high collagenase‐3 expression levels and poor prognosis in patients with head and neck cancer

Background. Squamous cell carcinoma of the head and neck (HNSCC) is a common cancer type. The ability for curative treatment with surgery and radiotherapy (RT) is usually highly dependent on tumor stage at the time of diagnosis. Methods. The purpose of this study was to determine whether the expression of a cancer-specific proteinase, collagenase-3 (matrix metalloproteinase-13 [MMP-13]), is associated with survival parameters in patients with HNSCC. We studied MMP-13 expression in tumors of 81 patients with stage I–IV HNSCC treated with surgery alone or in combination with radiotherapy. Results. We found a subgroup of patients with high MMP-13 expression level in their tumors (≥90% MMP-13–positive tumor cells) associated with unfavorable prognosis (median overall survival [OS], 11.8 vs 19.6 months, p = .032). In addition, the median disease-specific survival (DSS) time was markedly reduced in this subgroup (13.8 months vs 40.7 months, p = .062). When the subgroup of patients treated with a curative intent was studied, the same association was found in OS (13.8 vs 24.6 months, p = .023) and DSS (p = .004). In addition, there was a trend for association between ≥90% MMP-13 positivity and a recurrent tumor (p = .078) in curatively treated patients. Conclusions. The short survival time associated with high MMP-13 expression levels could not be predicted by tumor size or local lymph node invasion. These results show that a high MMP-13 expression level is associated with aggressiveness of HNSCC and may have prognostic value in patient evaluation. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005