Abstract
AbstractDNA‐ploidy and the percentage of S‐phase cells were measured by DNA flow cytometry in 171 primary squamous cell carcinomas of the head and neck. Of the analyzed tumors, 102 (60%) were aneuploid and 69 (40%) were diploid. Minimum follow‐up was 6 months (median: 37 months). For the whole population no difference of the 5‐year survival rate was found comparing diploid (18%) and aneuploid tumors (26%). Following sequential radiochemotherapy, aneuploid tumors revealed a better 5‐year survival (54%) than diploid tumors (7%; P < 0.01). Accordingly, the locoregional control rate was higher for aneuploid tumors (57% vs. 28%; n.s.). By contrast, following surgery and radiotherapy or concurrent radiochemotherapy, diploid and aneuploid tumors had nearly the same survival rates. The analysis of recurrence demonstrated a lower rate of locoregional failures of diploid tumors (surgery + radiotherapy: 32% vs. 44%), but this was leveled out by a higher incidence of distant metastases of diploid carcinomas (surgery + radiotherapy: 36% vs. 17%). Relating to the fraction of S‐phase cells, slowly proliferating tumors (S‐phase < median; 28%) had a better 5‐year survival rate than fast proliferating tumors (20%; P < 0.05). The same was true for different treatment modalities surgery + radiotherapy; concurrent or sequential radiochemotherapy) and for the investigated stage III and IV tumors according to UICC 1987. The analysis of recurrence revealed that the better survival of slowly proliferating tumors was explained by the higher locoregional control rate (60%) compared to fast proliferating tumors (45%; P < 0.05). Stepwise multivariate analysis revealed treatment modality (P = 0.107), S‐phase fraction (P = 0.026), and UICC stage (P = 0.044) as independent prognostic factors for locoregional recurrences and S‐phase fraction (P = 0.0143) for 3‐year overall survival. These data indicate that flow cytometrically evaluated DNA‐ploidy and S‐phase fraction have a relevant prognostic power for predicting the clinical outcome of squamous head and neck cancer. © 1993 Wiley‐Liss, Inc.
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