Prognostic implication of ERCC-1 protein expression in resected head and neck cancer

The excision repair cross-complement group 1 (ERCC1) expression is related to prognosis and sensitivity to platinum-based chemotherapy in various cancers, especially lung. Platinum is the most frequently chemotherapeutic used in treatment of squamous cell carcinoma of the head and neck cancer (SCCHN), and ERCC1 has been studied as a predictive biomarker of cisplatin-containing chemo or chemo-radiotherapy. In this study, we assessed the prognostic role of ERCC1 protein expression in surgically resected SCCHN. Between 1994 and 2012, 204 patients who were diagnosed with oropharynx or oral cavity cancer and underwent curative surgical resection were included. ERCC1 protein expression was evaluated by immunohistochemistry. Clinical and pathologic records were retrospectively reviewed. ERCC1 protein was positive in 136 (66.7%) patients. High ERCC1 expression was associated with oral cavity cancer (P < 0.001), well differentiated tumor (P = 0.036), and HPV negativity (P < 0.001). High ERCC1 expression showed trend toward poor prognosis but not statistically significant (P = 0.117 for PFS, P = 0.332 for OS). The prognostic role of ERCC1 was not different according to the HPV status or following chemo or radiotherapy. However, patients with high ERCC1 showed poor prognosis in advanced TNM stage (III/IV), but no difference in early stage (I/II). ERCC1 protein expression can help to predict prognosis in surgically resected oropharynx or oral cavity SCCHN, especially in advanced stage.