Abstract: Abstract: Objective To investigate the clinical significance of molecular biomarker (eIF4E, survivin, cyclin D1 and P27) expressions in defining the surgical margin in local advanced supraglottic laryngeal squamous cell carcinoma (LSCC) after induction chemotherapy. Methods A total of 95 patients with local advanced (T3-4, N0-2, M0) supraglottic LSCC were enrolled in this study. Clinical response was evaluated after induction chemotherapy with a TPF (docetaxel/ cisplatin/ fluorouracil) regimen. Fifty-nine patients with stable disease (SD) and partial remission (PR) and requiring surgery, were underwent partial laryngectomy. These patients were divided into three groups according to the shortest margin distances: <5 mm (Margin 1) group (n=14), 5-10 mm (Margin 2) group (n=17) and ＞10 mm (Margin 3) group (n=28). Tumors and the adjacent tissues were prepared for tissue microarray (TMA) and were used to identify the expressions of eIF4E, survivin, cyclin D1 and P27. The recurrence rates in three years were also analyzed. Results Primary tumors (T) showed necrosis and tumor retraction after chemotherapy. In Margin 1 group, the retraction zone was found in 10 cases (10/14), necrotic and degenerative tumor cells were occasionally found. No retraction zone was found in Margin 2 and Margin 3 groups. The expressions of eIF4E and survivin proteins were higher in primary tumors. The positive expression rates of eIF4E and survivin proteins decreased sharply with the increase of the margin in three groups. There were no significant differences in positive expressions of cyclin D1 and P27 between three groups. In 59 patients with laryngeal cancer, 12 (20.3%) recurred 3 years after operation, including 11 (78.6%) in Margin 1 group, 1 (5.9%) in Margin 2 group and 0 (5.9%) in Margin 3 group. The recurrence rate was significantly higher in Margin 1 group than that in Margin 2 and Margin 3 groups (P＜0.05). Conclusion The eIF4E and survivin proteins might be used as more sensitive molecular margin markers of partial laryngectomy after induction chemotherapy in patients with local advanced supraglottic LSCC. The margin beyond 10 mm and no expression of markers are relatively safe.

Key words: laryngeal neoplasms, induction chemotherapy, supraglottic laryngeal carcinoma, partial laryngectomy, molecular margins, tumor regression area