Survivin expression in laryngeal squamous cell carcinomas and its prognostic implications

We examined the expression of survivin using immunohistochemistry in 102 cases of laryngeal squamous cell carcinoma (LSCC). Overall, 65.7% (67 out of 102) of tumors were positive for survivin expression and significantly associated with tumor site, poor differentiation, tumor size, lymph node metastasis and advanced stage. Kaplan-Meier analysis showed that survivin expression was significantly associated with shorter disease-free and overall survival respectively. When survivin expression and clinical stage were combined, patients with both survivin-positive and advanced stage (III, IV) revealed poorer disease-free and overall survival when compared with the other cases (p = 0.0002 and p = 0.0002, respectively). Additionally, in early stage (I, II) cases, survivin expression also showed a significant prognostic trend for disease-free and overall survival (p = 0.0727 and p = 0.0701, respectively). By the multivariate analysis, tumor size, lymph node metastasis and survivin expression were independent prognostic factors both in disease-free and overall survival. These findings indicate that survivin expression is associated with unfavorable clinicopathological parameters and represents an independent marker for prognosis of LSCC.