Does Histologic Grade Have a Role in the Management of Head and Neck Cancers?

Fortin, A.; Couture, Christian; Doucet, René; Albert, Michele; Allard, Josée; Têtu, Bernard

doi:10.1200/jco.2001.19.21.4107

Cited by 66 publications

(44 citation statements)

References 65 publications

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“…Literature shows that high grading is associated with higher incidence of lymph node and distant metastasis [47] and correlates with a poor prognosis of oscc patients [47,48]. …”

Section: Discussionmentioning

confidence: 99%

Increased malignancy of oral squamous cell carcinomas (oscc) is associated with macrophage polarization in regional lymph nodes – an immunohistochemical study

Wehrhan

Büttner‐Herold

Hyckel³

et al. 2014

BMC Cancer

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BackgroundIt is largely accepted that specific immunological parameters in solid malignancies are associated with patient’s prognosis. Recently a correlation of macrophage polarization with histomorphological parameters could also be shown in oral squamous cell carcinoma (oscc). The observed tumor derived peripheral immune tolerance could be associated with the macrophage polarization in regional tumor draining lymph nodes.So far there are no studies analyzing the macrophage polarization in cervical lymph nodes of oscc patients. In the present study we aimed to correlate macrophage polarization in different anatomical lymph node compartments of patients diagnosed with oscc with histopathologic parameters of the primary tumor (T-, N-, L-, V-, Pn-status, grading).MethodsTumor free (n = 37) and metastatic (n = 17) lymph nodes of T1 and T2 oscc patients were processed for immunohistochemistry to detect CD68, CD11c, CD163 and MRC1 positive cells. Samples were digitized using whole slide imaging and the number of cells expressing the aforementioned markers in the region of interest quantitatively analyzed.ResultsThe malignancy of the primary tumor (defined by T-, L-, Pn-status, grading) correlated with the lymph node macrophage polarization. L1 and Pn1 tumor cases displayed a significantly (p < 0.05) decreased M1 and increased M2 polarization in the sinus of the lymph nodes. G3 cases presented a significantly (p < 0.05) increased M2 polarization in the sinus compared to G2 cases. T2 tumors had significantly (p < 0.05) increased M2 polarization in the interfollicular zone of regional lymph nodes compared to T1 tumors. Metastatic and non-metastatic lymph nodes did not differ regarding their macrophage polarization.ConclusionsThe current study revealed for the first time an influence of oscc on the macrophage polarization in regional lymph nodes. Markers of malignant behavior in the primary tumor were associated with a shift of macrophage polarization in lymph nodes from the anti-tumoral M1 type to the tumor-promoting M2 type. As tumor free and metastatic lymph nodes did not differ in terms of their macrophage polarization pattern, there must be other factors influencing the location for lymph node metastasis formation.

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“…Literature shows that high grading is associated with higher incidence of lymph node and distant metastasis [47] and correlates with a poor prognosis of oscc patients [47,48]. …”

Section: Discussionmentioning

confidence: 99%

Increased malignancy of oral squamous cell carcinomas (oscc) is associated with macrophage polarization in regional lymph nodes – an immunohistochemical study

Wehrhan

Büttner‐Herold

Hyckel³

et al. 2014

BMC Cancer

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“…In the past, poorly differentiated OPC was associated with worse outcomes, including increased regional and distant metastases and decreased metastasis-free survival [25,26,27,28]. However, more recent literature suggests that the poorly differentiated basaloid and nonkeratinizing subtypes of OPC are actually associated with positive HPV status and consequently are correlated with better prognoses and outcomes [29,30].…”

Section: Discussionmentioning

confidence: 99%

Radiologic Differences between Human Papillomavirus-Related and Human Papillomavirus-Unrelated Oropharyngeal Carcinoma on Diffusion-Weighted Imaging

Chan

Higgins²,

Enepekides³

et al. 2016

ORL

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Background and Purpose: Human papilloma virus-related oropharyngeal carcinoma (HPV+ OPC) is a unique entity compared to HPV-unrelated (HPV-) OPC. Previous studies were inconclusive regarding the differences between HPV+ and HPV- OPCs on diffusion-weighted imaging (DWI). This study sought to determine if there is an association between HPV status and apparent diffusion coefficient (ADC) values as an imaging biomarker in OPCs. Materials and Methods: OPC patients with pretreatment MRI including DWI were retrospectively reviewed and analyzed as a blinded, controlled cohort. HPV status was biopsy-ascertained with p16 staining. ADC values were determined by placing the largest possible circular region of interest in solid portions of primary tumors and/or metastatic lymph nodes. Necrotic and cystic portions were excluded. Results: Twenty-eight HPV+ and 12 HPV- patients were included. Adjusted for age and sex, ADC values were significantly lower in HPV+ OPC primary tumors (p = 0.013) and lymph node metastases (p = 0.013). The area under the curve (AUC) was 0.85 and 0.90, respectively. A model with a linear combination of the 2 variables yielded an AUC of 0.92. Conclusion: ADC values were significantly lower in both the primary tumors and lymph node metastases in HPV+ OPCs compared to HPV- OPCs. These results confirm the results of prior studies.

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“…The vast majority of the tumors in the western world are of squamous cell histology [3,4]. When the patients present with stage I or II disease they can, in most of the cases, be treated with surgery or radiotherapy with 5-year disease-free rates of 60-90%, depending on tumor site and probably histological grading [3][4][5]. More than half of the patients present in a locoregionally advanced stage.…”

Section: Introductionmentioning

confidence: 99%

Targeted therapies in head and neck cancer

Specenier

Vermorken

2007

Targ Oncol

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Does Histologic Grade Have a Role in the Management of Head and Neck Cancers?

Abstract: Patients with histologic grade 1 and grade 2 (except N3) are at low risk of DM. Patients with grade 2 and N3 or patients with grade 3 and N1 to N3 have a higher risk of distant metastases and should be considered for systemic treatment.

Cited by 66 publications

References 65 publications

Increased malignancy of oral squamous cell carcinomas (oscc) is associated with macrophage polarization in regional lymph nodes – an immunohistochemical study

Increased malignancy of oral squamous cell carcinomas (oscc) is associated with macrophage polarization in regional lymph nodes – an immunohistochemical study

Radiologic Differences between Human Papillomavirus-Related and Human Papillomavirus-Unrelated Oropharyngeal Carcinoma on Diffusion-Weighted Imaging

Targeted therapies in head and neck cancer

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