p53 mutations and chemoresistance in oromaxillofacial squamous-cell carcinomas. The results of a molecular genetics study of p53 in metastatic oromaxillofacial tumors and an evaluation of the response to neoadjuvant chemotherapeutic treatment

MATERIAL AND METHODS: The authors carried out a p53 genetic research on native DNA in 15 oral-maxillofacial squamous cell carcinomas, lymph nodes metastasis, treated with neoadjuvant chemotherapy, checking the p53 "status" and the clinical response to the chemotherapeutic treatment (three 5-FU/CDDP cycles). RESULTS: The authors found p53 mutations in 3/15 cases. In these cases, at post-chemo restaging, it resulted 2 progressions and 1 stability of disease. In the 12 cases with wildtype p53: 4 objective improvements and partial responses (PR), respectively, of 55% (1), 60% (1), 65% (1), 70% (1), 75% (2) and 90% (2). The 15 patients were treated then by surgery and adjuvant chemotherapy (three C-F cycles). These results seem to confirm the outcome of the researches "in vitro" and they provide first correlations between p53 mutations and chemoresistance in oral squamous cell carcinomas. The survival evaluation also, in the examined cases, shows, but with medium-term follow-up, the tendency to a poor prognosis when p53 is altered. CONCLUSIONS: This research outlines the possibility, also for oral and maxillofacial tumors, to utilize, p53 as a prognostic and chemoresponse marker, useful, with the otherwise well-known prognostic factors, for the evaluation of advanced cancers, in the interests of a more suitable therapeutic protocol.