Abstract
Between 1980 and 1985, 914 patients with head and neck squamous cell carcinoma underwent lymph node dissection in our institution. The prognostic value of clinical factors has already been reported (Mamelle et al, 1994, Am J Surg 168: 494-498). We present here a comparison of biological characteristics of pharyngeal tumours in patients who developed distant metastasis and in patients without metastasis, matched on tumour site, node site and size, and year of diagnosis. Tumour differentiation, keratinization, vascular emboli, immunohistochemical expression of p53, c-erb-B2, Rb and bcl2 were first assessed in 31 pairs of patients. Factors of potential interest were then determined in 32 additional pairs of patients. Statistical analysis showed that the risk of distant metastasis was halved in patients with tumours expressing c-erb-B2 compared with patients with c-erb-B2-negative tumours (P = 0.05). The significance of c-erb-B2 expression and its potential value as a prognostic factor is discussed.
Highlights
We reported on the prognostic value of clinical and anatomical factors in 914 patients who underwent neck surgery at the Gustave-Roussy Institute
Among the clinical factors studied in multivariate analysis, the location of the lymph node and its size were found to significantly predict the risk of distant metastasis and overall survival (Mamelle et al, 1994)
The seven histobiological parameters, namely differentiation and keratinization of the tumour, the presence of vascular emboli and immunohistochemical expression of p53, c-erb-B2, Rb and bcl2 were first evaluated in a series of 31 matched pairs of patients with oropharyngeal tumours
Summary
Between 1980 and 1985, 914 patients with HNSCC underwent lymph node dissection at our institute. The primary tumour site was the oral cavity (287), hypopharynx (249), larynx (247) and oropharynx (131). The treatment was standardized for each site. Among the clinical factors studied in multivariate analysis, the location of the lymph node (upper, middle, lower neck) and its size were found to significantly predict the risk of distant metastasis and overall survival (Mamelle et al, 1994). The first part of the study included patients with an oropharyngeal tumour: 40 of the 131 patients with oropharyngeal tumours Oropharynx Metastasis. No metastasis (31) Ta Ti T2 T3 T4. An exact conditional logistic regression method performed with LogXact (Mehta and Patel, 1995) was used for the analysis. The P-values presented correspond to exact-score tests
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