Prognostic Value of Epithelial Cell Adhesion Molecules in T1-2N0M0 Glottic Cancer

Laryngoscope. 2021 Jul;131(7):1522-1527. doi: 10.1002/lary.29348. Epub 2020 Dec 28.


Objective: This is an ancillary study of a multi-institutional randomized non-inferiority phase III trial of accelerated fractionation (AF) versus standard fractionation (SF) radiation therapy for T1-2N0M0 glottic cancer (JCOG0701). Biopsy specimens of tumors from the patients enrolled in the JCOG0701 are collected and the association between clinical outcomes and histopathologic features such as expression of epithelial cell adhesion molecule (EpCAM), p53, and p16 were investigated.

Methods: Five slices of undyed slides from biopsy specimens were sent to the National Cancer Center Hospital and all the specimens were assessed for the expression of EpCAM, p53, and p16. The primary objective was to investigate the association between 3-year progression-free survival (PFS) and expression of EpCAM, p53, and p16.

Results: A total of 88 out of 370 patients were enrolled in this ancillary study. The 3-year PFS for tumors with strong expression of EpCAM was 70.6% (95% CI 43.1%-86.6%), while that of tumors without strong expression of EpCAM was 77.5% (95% CI 65.9%-85.5%) with no remarkable difference between groups (P = .67). Likewise, there was no significant difference in 3-year PFS between tumors regardless of p53 or p16 status. However, in a subgroup analysis for 17 patients with a strong expression of EpCAM, AF showed better 3-year PFS than SF (100% vs 54.5%, P = .07).

Conclusions: From the current study, it could not be concluded that EpCAM, p16, and p53 were prognostic factors for early-stage glottic cancer after primary radiation therapy. AF might be an appropriate fractionation for tumors with a strong expression of EpCAM.

Level of evidence: 3 Laryngoscope, 131:1522-1527, 2021.

Keywords: EpCAM; Glottic cancer; accelerated fractionation; an ancillary study; randomized trial.

Publication types

  • Clinical Trial, Phase III
  • Equivalence Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / metabolism
  • Biopsy
  • Cyclin-Dependent Kinase Inhibitor p16 / analysis
  • Cyclin-Dependent Kinase Inhibitor p16 / metabolism
  • Disease Progression
  • Dose Fractionation, Radiation*
  • Epithelial Cell Adhesion Molecule / analysis
  • Epithelial Cell Adhesion Molecule / metabolism
  • Female
  • Glottis / pathology*
  • Humans
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Progression-Free Survival
  • Tumor Suppressor Protein p53 / analysis
  • Tumor Suppressor Protein p53 / metabolism


  • Biomarkers, Tumor
  • CDKN2A protein, human
  • Cyclin-Dependent Kinase Inhibitor p16
  • EPCAM protein, human
  • Epithelial Cell Adhesion Molecule
  • TP53 protein, human
  • Tumor Suppressor Protein p53