Biomedical subjects

Luiz Paulo Kowalski

Publications and source records attributed to Luiz Paulo Kowalski.

At least 19 recordsLinked to original sources

PubMed2025

Comparative analysis of convolutional neural network models for the histopathological differentiation of acinic cell carcinoma and secretory carcinoma.

OBJECTIVE: Although artificial intelligence tools show promise for enhancing the diagnosis of head and neck lesions, few studies have tested these resources for the microscopic diagnosis of salivary gland tumors. Specifically, the microscopic differentiation between acinic cell carcinoma and secretory carcinoma has never been addressed in this context. Therefore, this exploratory study aimed to comparatively evaluate the feasibility of applying convolutional neural networks for the microscopic differentiation between acinic cell carcinomas and secretory carcinomas. METHODS: A cross-sectional study using whole-slide images from 46 patients with acinic cell carcinoma (n = 26) or secretory carcinoma (n = 20) was conducted. Eight CNNs (ResNet-50, InceptionV3, VGG16, Xception, MobileNet, DenseNet121, EfficientNetB0, and EfficientNetV2B0) were trained and evaluated for accuracy, sensitivity, specificity, F1-score, and AUC. Performance was measured in training, validation, and test subsets. Accuracy and loss curves were also presented. RESULTS: InceptionV3 demonstrated the best overall performance, with the lowest loss (1.39), highest accuracy (0.81), sensitivity (0.90), and F1-score (0.81). VGG16 achieved the highest AUC (0.86) and precision (0.77). DenseNet121 showed the lowest performance in terms of accuracy (0.65) and F1-Score (0.52), but the highest specificity (0.85). CONCLUSION: This proof-of-concept study suggests that convolutional neural networks may be feasible tools to support the microscopic differentiation between acinic cell carcinoma and secretory carcinoma. The performance of these models critically depends on the size of the dataset and the quality of annotations. The findings should be interpreted cautiously given the limited dataset and potential sources of bias. Further validation with larger, multicenter datasets is needed before any clinical application can be considered.

Humans↗

PubMed2006

Clinicopathological and immunohistochemical evaluation of oral squamous cell carcinoma in patients with early local recurrence.

Early local recurrence is one of the main causes of treatment failure after definitive therapy of oral squamous cell carcinoma (OSCC), contributing significantly for the relative low survival rates of this neoplasia. The aim of this study was to investigate the clinical, histological and molecular factors involved in early local recurrence of OSCC, which may lead to better risk assessment in some specific cases. Twenty-seven patients with early recurrent OSCC were matched with 54 patients with the same clinical stage and tumor site but without local recurrence, in a pair-matched study design. All cases were evaluated in relation to the clinicopathological features and immunohistochemical expression of Ki-67, p53, bcl-2, FAS, Erb-B2, beta-catenin, and E-cadherin. The variables associated with ELR were alcohol consumption (p=0.019), treatment performed (p=0.041), and expression of Ki-67 (p=0.028), FAS (p=0.005) and membrane beta-catenin (p=0.026). The multivariate survival analysis (Cox regression) showed that surgery with adjuvant radiotherapy [OR=0.26 (95% CI, 0.1-0.6)] and FAS expression [OR=0.21 (95% CI, 0.1-0.5)] had a significant effect for ELR development. Radiotherapy had no significant impact on patients' overall survival. Therefore, both treatment and molecular characteristics of the tumor seem to be involved in early local recurrence.

Alcohol Drinking↗

PubMed2006

Salvage for cervical recurrences of head and neck cancer with dissection and interstitial high dose rate brachytherapy.

Salvage therapy in head and neck cancer (HNC) is a controversy issue and the literature is scarce regarding the use of interstitial high-dose rate brachytherapy (I-HDR) in HNC. We evaluated the long-term results of a treatment policy combining salvage surgery and I-HDR for cervical recurrences of HNC. Charts of 21 patients treated from 1994 to 2004 were reviewed. The crude local control rate for all patients was 52.4%. The 5- and 8-years overall (OS) and local relapse-free survival (LRFS) rates were 50%, 42.9%, 42.5% and 28.6%, respectively. The only predictive factor associated to LFRS and OS was negative margin status (p = 0.0007 and p = 0.0002). We conclude that complete surgery is mandatory for long term control and the doses given by brachytherapy are not high enough to compensate for microscopic residual disease after surgery.

Adult↗

PubMed2006

Socioeconomic effects of and risk factors for disability in long-term survivors of head and neck cancer.

OBJECTIVE: To evaluate the socioeconomic effect of and risk factors for work-related disability due to head and neck cancer and its treatment. DESIGN: Cross-sectional analysis of a consecutive series of patients. SETTING: Tertiary cancer center hospital. PATIENTS: Eligible patients had squamous cell carcinoma of the upper aerodigestive tract, were employed or had an active professional career at the time of initial diagnosis, and were disease free for at least 2 years at the time of interview. The survey instruments were a specific questionnaire to evaluate patient socioeconomic status and a Portuguese version of the University of Washington Quality of Life questionnaire. MAIN OUTCOME MEASURES: Descriptive analysis of the results and associations between clinical, social, and quality of life variables with work disability. RESULTS: A total of 301 patients were studied. There were 236 (78.4%) men (median age, 52 years). The tumor sites were the oral cavity in 158 (52.5%), oropharynx in 55 (18.3%), larynx in 78 (25.9%), and hypopharynx in 10 (3.3%). Most patients presented with advanced clinical disease and underwent surgical treatment initially. There were 36 (12.0%) illiterate patients, and only 23 (7.6%) patients had completed college. Ninety-nine patients (32.9%) became unable to work, and 126 (41.9%) reported a significant decrease in household income. Multivariate analysis showed that advanced clinical stage (P = .02), alcohol consumption (P = .02), and low educational level (P = .007) were associated independently with work disability. CONCLUSIONS: We observed a high rate of work-related disability that led to significant decrease in household income. Several clinical, social, and quality of life variables were associated with this degree of disability. These results could be used to better define who should undergo more intensive rehabilitation aiming to reduce work disability. If intensive rehabilitation is unsuccessful, these patients should receive more comprehensive social support.

Adolescent↗

PubMed2006

Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer.

BACKGROUND: Therapeutic decisions in recurrent oral and oropharyngeal squamous carcinoma (SCC) remain controversial. METHODS: Two hundred forty-six consecutive patients who underwent salvage surgery for recurrent squamous cell carcinoma (SCC) of the oral cavity and oropharynx were studied. The tumor sites were lip, 33 cases; oral cavity, 143; oropharynx, 70. The previous treatment was surgery in 73 patients, radiotherapy in 96, combined surgery and radiotherapy in 76, and chemotherapy in one. The clinical stage of recurrence was I/II in 51 cases and III/IV in 195 cases. The disease-free interval (DFI) was less than 1 year in 156 cases and greater than 1 year in 90 cases. RESULTS: The rate of recurrence was 54.9%, and the overall 5-year actuarial survival rate was 32.3%. The significant prognostic factors in multivariate analysis were restage (p = .049) and DFI (p = .045). CONCLUSION: Patients with recurrent oral and oropharyngeal SCC at initial clinical stages (rCS I and II) and with a DFI greater than 1 year had a favorable prognosis.

Adult↗

PubMed2006

Brazilian-Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer.

BACKGROUND: The University of Washington Quality of Life (UW-QOL) questionnaire is an English-language survey instrument used worldwide to assess the quality of life of patients with head and neck cancer. To be used in other cultures, such instruments require careful translation and psychometric validation in other languages. METHODS: The translation and cultural adaptation of the questionnaire were performed following accepted international guidelines. The psychometric validation was performed on a consecutive series of patients with at least 1 year of disease-free survival after treatment for squamous cell carcinoma of the upper aerodigestive tract, recruited from October 2004 to January 2005 from a tertiary cancer center hospital. Eligible subjects were invited to complete the Portuguese version of the UW-QOL questionnaire during routine clinical consultation and complete it again within 15 days. They also completed a validated Portuguese version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and a questionnaire to evaluate anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]). RESULTS: A Portuguese version of the questionnaire was developed in iterative fashion. In the psychometric validation process, a total of 109 patients were analyzed. Reliability was excellent, including both internal consistency (Cronbach's alpha [alpha] of 0.744) and test retest reliability (intraclass correlation coefficient [ICC] of 0.882). Construct validity was supported by statistically significant relationships between the SF-36 and HAD questionnaires and the translated UW-QOL questionnaire. CONCLUSIONS: The Brazilian-Portuguese version of the UW-QOL questionnaire appears to be culturally appropriate and psychometrically valid. This version is a valuable tool to evaluate accurately the quality of life of Brazilian patients with head and neck cancer.

Adult↗

PubMed2006

Voice and vocal self-assessment after thyroidectomy.

BACKGROUND: Voice alterations after thyroidectomy can be found even with preserved function of laryngeal nerves. The purpose of this study was to evaluate voice before and after thyroid surgery and the role of orotracheal intubation on voice changes. METHODS: We conducted a prospective nonrandomized study of patients who underwent thyroid surgery and compared the results with a control group of patients who underwent breast surgery. Subjects underwent a videolaryngoscopic exam, a subjective and an objective voice analysis and a Voice Handicap Index (VHI) questionnaire before and after surgery. RESULTS: A total of 100 patients who underwent thyroidectomy and 30 who underwent breast surgery were studied. Both groups were similar in demographic, clinical, and surgical variables. Postoperative videolaryngoscopy showed larynx alterations in 28% of the thyroidectomized patients, without significant alterations in the control group. There were subjective voice changes in 29.7% of the patients without vocal fold immobility after thyroid surgery and no statistically significant changes after breast surgery. Acoustic analysis showed significant increased values in the voice turbulence index (VTI) parameter in both groups, although higher in the thyroid one. In the VHI assessment, voice complaints were more frequently registered in the thyroid group rather than in the control group. CONCLUSIONS: Voice alterations are frequent after thyroidectomy even with preserved vocal fold mobility. Such alterations were more frequently detected in that group than in patients who underwent breast surgery. Orotracheal intubation is just one of the multiple factors involved.

Adolescent↗

PubMed2006

Oral verrucous carcinoma: a retrospective study in São Paulo Region, Brazil.

Oral verrucous carcinoma (OVC) is a rare variant of squamous cell carcinoma with a characteristic morphology and specific behavior. To date, few studies are available focusing the prevalence and clinicopathologic features of the oral verrucous carcinoma in Brazilian population. A total of 3,500 primary oral well-differentiated squamous cell carcinoma surgically excised in the A.C. Camargo Cancer Hospital and Amaral Carvalho Cancer Hospital, Brazil, from 1980 to 2000 were retrospectively reviewed. Twenty cases of verrucous carcinomas were identified, most of them occurring in older male with age above the sixth decade, the sites frequently affected being the lower lip and the hard palate. Microscopically, the tumor showed a heavily keratinized lesion with compressive invasion pattern, little atypia, and free surgical margins. The local recurrence was verified in 38.5% of the patients with oral verrucous carcinoma; however, regional recurrence and distant metastasis were not verified. The results suggest that, although it is less frequent and with excellent prognosis, the verrucous carcinoma presents a potential for local recurrence that should be considered during the surgical planning of this neoplasm in the oral cavity.

Adult↗

PubMed2006

Adenoid cystic carcinoma and mucoepidermoid carcinoma of the maxillary sinus: report of a 44-year experience of 25 cases from a single institution.

PURPOSE: The aim of this study was to analyze the clinicopathologic characteristics of all cases of adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC) arising in the maxillary sinuses treated in a single institution. PATIENTS AND METHODS: From 1953 to 1997, 18 ACCs and 7 MECs from the maxillary sinus were studied. Clinical data were obtained from the medical records and microscopic slides were reviewed. RESULTS: Mean age was 45.9 years (range, 13 to 77 years) and TNM staging revealed 88.9% of ACCs at advanced clinical stages, while 57.1% of the MECs were initial clinical stages. Surgery combined with radiotherapy was the most common treatment. Follow-up showed 88.8% of ACC patients died from the tumor, while 42.8% of patients with MEC are alive without disease. CONCLUSION: Maxillary sinus ACC and MEC are uncommon tumors and a patient's prognosis depends on the clinical stage and histologic type; MEC has shown a better outcome.

Adolescent↗

PubMed2006

Clinicopathologic and immunohistochemical study of intraoral mucoepidermoid carcinoma.

OBJECTIVE: The purpose of this study is to assess the clinicopathologic and immunohistochemical features of intraoral mucoepidermoid carcinomas and its relationship with the prognosis. STUDY DESIGN AND SETTING: From 1953 to 1993, 27 patients with intraoral mucoepidermoid carcinomas surgically treated were selected for this study. Clinical data were obtained from the medical records, the microscopic slides were reviewed, the tumors were graded, and immunohistochemical analysis for p53, PCNA, cerbB-2, and CEA were carried out. RESULTS: The tumors were more frequent in patients between 40 and 60 years of age (40.7%), without gender predilection. Hard palate was the most common site with 13 cases (48%). T2 was the more frequent stage (48%) and 2 patients (7.4%) were staged as N+. Most tumors (48%) were classified as low grade of malignancy. The expression of PCNA was associated to high-grade tumors (P = .00610) and c-erbB-2 to low grade tumors (P = .03958). No recurrence was noted in most of the cases (22 cases, 81.5%). Three cases (11.1%), however, showed local recurrence and 2 patients (7.4%) died because of the disease. The analysis of the overall survival rate showed that male patients (P = .04249), stage N (P = .05948), high grade of malignancy (P = .0009), strong expression of PCNA (P = .09128), and weak expression of c-erbB-2 (P = .03334) had the lowest survival rates. CONCLUSION: Our results showed that patients with intraoral mucoepidermoid carcinoma had a reduced survival expectation if they were of the male gender, with regional metastasis, high grade of malignancy, strong expression of PCNA and weak expression of c-erbB-2. EBM RATING: C-4.

Adult↗

PubMed2006

H19-DMR allele-specific methylation analysis reveals epigenetic heterogeneity of CTCF binding site 6 but not of site 5 in head-and-neck carcinomas: a pilot case-control analysis.

Aberrant methylation of seven potential binding sites of the CTCF factor in the differentially methylated region upstream of the H19 gene (H19-DMR) has been suggested as critical for the regulation of IGF2 and H19 imprinted genes. In this study, we analyzed the allele-specific methylation pattern of CTCF binding sites 5 and 6 using methylation-sensitive restriction enzyme PCR followed by RFLP analysis in matched tumoral and lymphocyte DNA from head-and-neck squamous cell carcinoma (HNSCC) patients, as well as in lymphocyte DNA from control individuals who were cancer-free. The monoallelic methylation pattern was maintained in CTCF binding site 5 in 22 heterozygous out of 91 samples analyzed. Nevertheless, a biallelic methylation pattern was detected in CTCF binding site 6 in a subgroup of HNSCC patients as a somatic acquired feature of tumor cells. An atypical biallelic methylation was also observed in both tumor and lymphocyte DNA from two patients, and at a high frequency in the control group (29 out of 64 informative controls). Additionally, we found that the C/T transition detected by HhaI RFLP suppressed one dinucleotide CpG in critical CTCF binding site 6, of a mutation showing polymorphic frequencies. Although a heterogeneous methylation pattern was observed after DNA sequencing modified by sodium bisulfite, the biallelic methylation pattern was confirmed in 9 out of 10 HNSCCs. These findings are likely to be relevant in the epigenetic regulation of the DMR, especially in pathological conditions in which the imprinting of IGF2 and H19 genes is disrupted.

Adult↗

PubMed2005

Prognostic factors in head and neck adenoid cystic carcinoma.

The aim of this study was to analyse the clinical, histological and immunohistochemical prognostic factors of a large series of adenoid cystic carcinoma, using univariate and multivariate survival analyses. All cases of head and neck ACC (n = 129) treated in a single institution in Brazil, between 1955 and 1997, were selected for the study. Univariate survival analysis revealed that age older than 45 years (p = 0.04), period of complaints inferior to 18 months (p = 0.007), presence of paresthesia (p = 0.04), T stage (p = 0.01), N stage (p = 0.04), M stage (p < 0.001), clinical stage (p = 0.003), solid histological type ( p< 0.001), presence of residual tumor (p < 0.001) and expression of p53 (p = 0.08) correlated with a poor prognosis. In the multivariate survival analyses, clinical stage, solid histological subtype and increased expression of p53 were independent significant prognostic factors. According to our findings, clinical stage, solid growth pattern and expression of p53 were the most important prognostic factors in patients with ACC.

Adolescent↗

PubMed2005

[Swallowing after chemotherapy and radiotherapy for laryngeal and hypopharyngeal carcinomas].

UNLABELLED: The main goals of the larynx preservation protocol are eradication of cancer and preservation of a functional larynx with maintenance of respiration, phonation and swallowing. Few studies, however have addressed functional outcomes. OBJECTIVE: Functional evaluation of oropharyngeal swallowing in patients enrolled in a larynx preservation protocol at the Hospital do Câncer AC Camargo. METHODS: Evaluation of swallowing was performed by videofluoroscopy in 31 patients, focusing on: oropharyngeal motility disorders, stasis, laryngeal penetration, aspiration and severity of dysphagia. RESULTS: Swallowing analysis: 5 patients showed inefficient bolus preparation, 14 had changes in the bolus propulsion; 23 patients had a reduced laryngeal elevation, 26 presented with stasis in the vallecula and 14 with stasis in hypopharynx. Nine patients presented silent aspiration. We detected functional swallowing in 11 patients; mild dysphagia in 7; mild/moderate in 7; moderate in 3 and severe dysphagia in 3. CONCLUSION: Larynx preservation results in changes of swallowing, ranging in their majority from discrete to moderate. Some patients, however, developed severe dysphagia, and oral feeding was not possible.

Adult↗

PubMed2005

Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database.

Despite recent advances in the diagnosis and treatment of head and neck cancer, there has been little evidence of improvement in 5-year survival rates over the last few decades. To determine more accurate trends in site-specific outcomes as opposed to a more general overview of head and neck cancer patients, we analyzed the site-specific data collected in the Surveillance, Epidemiology, and End Results-SEER Public-Use Database 1973-1999. Based on the selection criteria, 96,232 cases were evaluated for trend analysis in incidence, clinical stage, treatment and 5-year survival. During the period 1973-1999, site-specific incidence rates for head and neck cancer changed significantly. Site-specific analysis of survival from 1974-1997 showed significant improvements in 5-year survival rates for cancers of the nasopharynx, oropharynx and hypopharynx (38.1% to 56.7% for nasopharynx, p < 0.001; 36.3% to 49.1% for oropharynx, p = 0.001 and 28.3% to 33.3% for hypopharynx, p = 0.015). The prognosis for early-stage salivary gland cancer during 1983-1997 and late-stage larynx cancer during 1974-1997 also demonstrated improvement (82.7% to 88.5%, p = 0.012 and 22.2% to 38.3%, p = 0.013, respectively). On the other hand, the prognosis for regional stage oral cavity cancer as well as early-stage larynx cancer patients declined during 1983-1997 (49.2% to 43.8%, p = 0.032 and 82.3% to 74.3%, p = 0.002, respectively). Site-specific changes in treatment and staging were also noted. Site-specific analysis allows for a more accurate description of incidence, staging, treatment, and prognostic trends for head and neck cancer.

Adult↗

PubMed2005

Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma.

The presence of distant metastasis after the initial treatment of head and neck squamous cell carcinoma is not considered a common event and is associated with a poor outcome. The objective of this study was to investigate the prevalence and risk factors associated with the diagnosis of distant metastasis in oral and oropharyngeal carcinoma patients. The medical charts of 2327 patients treated from 1954 to 1997 were reviewed. They were 1703 patients (73.2%) with oral cavity and 624 (26.8%), oropharyngeal tumours. Regarding the primary treatment: 637 patients (27.4%) underwent surgery alone; 1147 (49.3%), radiotherapy alone and 543 (23.3%), combined treatment (surgery and radiotherapy). During the follow-up period after the initial treatment, 89 patients (3.8%) were diagnosed with distant metastasis. The variables associated with the distant metastasis-free survival were: tumour site (p=0.008); T stage (p<0.001); N stage (p<0.001); treatment performed (p<0.001) and decade of admission at the institution (p<0.001). The multivariate analysis (Cox regression) showed that the clinical stage (p=0.007); treatment performed (p=0.012) and decade of admission at the institution (p=0.004) were independent predictive factors for distant metastasis. Distant metastasis has been diagnosed more frequently in the latter decade and the significant predictors associated with its presence were the advanced clinical stage and patients who had undergone combined treatment.

Adult↗

PubMed2005

Dedifferentiated liposarcoma of the oral cavity with angiosarcomatous dedifferentiation.

We report a unique case of a 42-year-old woman with a dedifferentiated liposarcoma of the soft tissue of the oral cavity with angiosarcomatous dedifferentiation. Liposarcomas compromising the head and neck region are very unusual, and most of the cases in oral cavity show a well-differentiated pattern. Dedifferentiation in liposarcomas occurs in about 10% of the cases and, when it occurs, the dedifferentiated areas usually resemble high-grade fibrosarcoma or pleomorphic sarcoma. Divergent differentiation might also occur. To the best of our knowledge, there are only nine cases of dedifferentiated liposarcoma of the oral cavity, none of which show an angiosarcomatous dedifferentiation.

Adult↗

PubMed2005

Large-scale transcriptome analyses reveal new genetic marker candidates of head, neck, and thyroid cancer.

A detailed genome mapping analysis of 213,636 expressed sequence tags (EST) derived from nontumor and tumor tissues of the oral cavity, larynx, pharynx, and thyroid was done. Transcripts matching known human genes were identified; potential new splice variants were flagged and subjected to manual curation, pointing to 788 putatively new alternative splicing isoforms, the majority (75%) being insertion events. A subset of 34 new splicing isoforms (5% of 788 events) was selected and 23 (68%) were confirmed by reverse transcription-PCR and DNA sequencing. Putative new genes were revealed, including six transcripts mapped to well-studied chromosomes such as 22, as well as transcripts that mapped to 253 intergenic regions. In addition, 2,251 noncoding intronic RNAs, eventually involved in transcriptional regulation, were found. A set of 250 candidate markers for loss of heterozygosis or gene amplification was selected by identifying transcripts that mapped to genomic regions previously known to be frequently amplified or deleted in head, neck, and thyroid tumors. Three of these markers were evaluated by quantitative reverse transcription-PCR in an independent set of individual samples. Along with detailed clinical data about tumor origin, the information reported here is now publicly available on a dedicated Web site as a resource for further biological investigation. This first in silico reconstruction of the head, neck, and thyroid transcriptomes points to a wealth of new candidate markers that can be used for future studies on the molecular basis of these tumors. Similar analysis is warranted for a number of other tumors for which large EST data sets are available.

Alternative Splicing↗

PubMed2005

Prognostic impact of p53, c-erbB-2 and epidermal growth factor receptor on head and neck carcinoma.

CONTEXT: p53, c-erbB-2 and epidermal growth factor receptor (EGFR) are cancer-related proteins that are usually expressed in head and neck squamous cell carcinoma (SCC). Their prognostic value remains controversial. OBJECTIVE: To evaluate the prognostic impact of p53, c-erbB-2 and EGFR expression in head and neck SCC. TYPE OF STUDY: Prospective. SETTING: Head and Neck Surgery Department, Hospital AC Camargo, São Paulo. METHODS: Fifty-four patients were studied for p53, c-erbB-2 and EGFR expression in head and neck SCC and adjacent mucosa, via immunohistochemistry. These data were correlated with histoclinical data and survival. RESULTS: There was a direct association of p53 expression in SCC and mucosa (p = 0.001); loss of c-erbB-2 expression (-) from normal mucosa to SCC (p = 0.04); lower frequency of association of c-erbB-2 (+) with EGFR (-) in SCC (p = 0.02); and a direct association of EGFR (+) expression in SCC and mitotic index (p = 0.03). The 60-month actuarial survival rates for patients presenting lymph node metastasis were higher when there was no capsule rupture by SCC (48.3%; p = 0.02), no more than one positive lymph node (52.3%; p = 0.004) or clear surgical margins (47.0%; p = 0.01), in comparison with patients presenting capsule rupture (20.2%), two or more positive lymph nodes (18.7%) or compromised surgical margins (0.0%), respectively. Patients presenting SCC p53 (+) and EGFR (-) demonstrated greater survival (75.0%; p = 0.03) than for the remaining group (33.1%). Multivariate analysis confirmed the positive impact of p53 (+) and EGFR (-) on survival (p = 0.02). DISCUSSION: Associations were found for p53, c-erbB-2 and EGFR expression with histoclinical data and prognosis. Interestingly, these results suggest that loss of mucosal c-erbB-2 expression could be involved in SCC carcinogenesis; EGFR expression in SCC is related to tumor mitotic index; and presence of p53 with absence of EGFR expression in head and neck SCC may be a prognostic factor for survival. CONCLUSIONS: Further prospective studies should be conducted to confirm the influence of p53, c-erbB-2 and EGFR on histoclinical data and prognosis.

Adult↗