Value of HIF-1α as an independent prognostic indicator in oral squamous cell carcinoma

Evaluation of: Eckert AW, Schutze A, Lautner MHW, Taubert H, Schubert J, Bilkenroth U. HIF-1α is a prognostic marker in OSCC. Int. J. Biol. Markers 25(2), 87-92 (2010). Oral squamous cell carcinoma is the most common cancer in the oral cavity, accounting for 95% of all malignancies. Predicting prognosis and survival of oral cancer patients has been challenging. To date, there are no molecular markers that can be used reliably in routine clinical practice, other than clinical and histological parameters. Numerous molecules have been tested in order to achieve the above objective. Hypoxia-inducible factor (HIF)-1α is a molecule that is mainly activated under hypoxic conditions. According to the article under evaluation, tumors negatively or weakly expressing HIF-1α had a 5-year disease-specific survival of 80% or more, whereas the disease-specific survival in cases with moderate or strong HIF-1α expression was only 49.4 and 33.6%, respectively. The mean disease-specific survival time was 54 months for patients whose tumors showed negative or weak HIF-1α expression, whereas patients with moderate or strong HIF-1α expression survived on average only 38 months (p = 0.001). HIF-1α may have a role to play in diagnostic and clinical practice to predict prognosis of oral cancer, provided the findings are confirmed by more reliable investigations in addition to immunohistochemistry analysis.