LARYNGOLOGY A prognostic role for Nm23-H1 in laryngeal carcinoma treated with postoperative radiotherapy: an introductory investigation Marco Lionello • Stella Blandamura • Marco Agostini • Claudia Staffieri • Andrea Lovato • Giulia Tealdo • Niccolo ` Favaretto • Luciano Giacomelli • Lucio Loreggian • Alberto Staffieri • Gino Marioni Received: 27 April 2012 / Accepted: 19 July 2012 / Published online: 3 August 2012 Ó Springer-Verlag 2012 Abstract Postoperative RT is generally recommended for laryngeal carcinomas (LSCCs) at high risk of recur- rence after surgery. There are currently no clinicopatho- logical parameters available to predict response to such adjuvant RT in LSCC, and only a few potentially predic- tive biomarkers have been investigated. Nm23-H1 protein is reportedly related to the tumor cells’ metastatic potential, and low Nm23-H1 expression levels in human carcinomas often correlate with a poor prognosis. The novel aim of the present preliminary study was to investigate the prognostic value of Nm23-H1 expression and subcellular localization in a series of patients given postoperative RT for LSCC. A retrospective clinicopathological investigation was conducted at an academic tertiary referral center of 28 consecutive patients given postoperative RT for LSCC. Image analysis of immunohistochemical reactions was performed to measure Nm23-H1 total and nuclear expression levels. Disease-free survival (DFS) was significantly shorter among LSCC patients with total Nm23-H1 levels \ 50.0 % (p = 0.03); the mean total Nm23-H1 expression was lower in patients with recurrent disease than in patients without it (statistical trend, p = 0.07). The disease recurrence rate was significantly higher (p = 0.021) and the DFS shorter (statistical trend, p = 0.052) among LSCC patients with nuclear Nm23-H1 levels \ 5.0 %. The locoregional recur- rence-risk ratio in LSCC patients with nuclear Nm23-H1 levels \ 5.0 % was 9.16. Nm23-H1 warrants further investigation of its potential role as a predictive biomarker with a view to providing tailored treatments after surgery, such as combinations of chemotherapy and RT instead of RT alone, in patients whose LSCCs have low or no Nm23-H1 expression. Keywords Nm23-H1 Á Laryngeal carcinoma Á Subcellular localization Á Postoperative radiotherapy Á Prognosis Introduction No clinicopathological parameters are currently available to predict the response of laryngeal squamous cell carci- noma (LSCC) to adjuvant radiotherapy (RT). Few studies have investigated the molecular pathways potentially cor- relating with how LSCC responds to postoperative RT in clinical settings. M. Lionello Á A. Lovato Á G. Tealdo Á N. Favaretto Á A. Staffieri Á G. Marioni (&) Department of Neurosciences, Otolaryngology Section, University of Padova, Via Giustiniani 2, 35128 Padua, Italy e-mail: gino.marioni@unipd.it S. Blandamura Á L. Giacomelli Department of Medicine, Anatomic Pathology Section, University of Padova, Padua, Italy M. Agostini Department of Surgical, Oncological and Gastroenterological Sciences, 2nd Surgical Clinic, University of Padova, Padua, Italy M. Agostini Department of Nanomedicine, The Methodist Hospital Research Institute, Houston, USA M. Agostini Istituto di Ricerca Pediatrica, Citta ` della Speranza, Padua, Italy C. Staffieri Department of Neurosciences, Otolaryngology Section, Treviso Branch, University of Padova, Treviso, Italy L. Loreggian Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy 123 Eur Arch Otorhinolaryngol (2013) 270:197–203 DOI 10.1007/s00405-012-2133-1