Evaluation of Prognostic Significance of the Expression of p53, Cyclin D1, EGFR in Advanced Oral Squamous Cell Carcinoma after Chemoradiation—A Systematic Review

Abstract

The majority of all head and neck tumours are squamous cell carcinomas (SCC). Recent advancements have assisted in producing a body of evidence for the genetic origins of these tumours. Identifying prognostic biomarkers in oral SCC would be of great importance in predicting tumour behaviour and in treatment planning. Many studies have proved that chemotherapy given with radiotherapy leads to better treatment outcomes and overall survival. Biomarkers like p53, cyclin D1, and EGFR, that regulate the cell cycle, have a pivotal role in tumour development and progression. This systematic review aims at analysing the prognostic significance of the expression of p53, cyclin D1, and EGFR in advanced oral SCC after chemoradiation therapy (CRT). A systematic search using predetermined keywords and inclusion/exclusion criteria was conducted in Medline/PubMed, Google Scholar, and other databases to identify relevant articles answering the research question “Does the expressions of p53, cyclin D1, and EGFR have a prognostic significance in recurrent oral SCC treated with chemoradiation?” Literature screening revealed eight articles that were considered for this study. The overexpression of p53, cyclin D1, EGFR was associated with the recurrence of the tumour, and pathologic response can be considered as a prognostic marker. However, the recurrence pattern not only depends on the biomarkers but also on the clinicopathologic factors that play a pivotal role in survival rates among oral cancer patients. The standard management of advanced head and neck SCC has been controversial. It has been concluded that concomitant therapy can result in better treatment outcomes. Clinicians need to scrutinize and evaluate p 53, cyclin D1 and EGFR as a diagnostic parameter for post tumour chemoradiation therapy. Personalised therapy strategies can be created for individual patients using biologically guided tumour characterization, which will enhance quality of life. Thus, the application of more sophisticated technology must be implemented for a better analysis of the tumour.