Prospective evaluation of cell kinetics in head and neck squamous carcinoma: the relationship to tumour factors and survival

Abstract

Summary Tumour growth rates were measured in 105 patients using in vivo incorporation of bromodeoxyuridine (BrdU) and investigated for any relationship to tumour factors or survival. The median labelling index (LI) was 8.7%, the duration of S-phase (Ts) was 14 h and the potential doubling time (Tpo) was 5.9 days. The labelling index in aneuploid tumours was significantly higher than that in diploid tumours. However the total labelling index (TLI) did not differ significantly between aneuploid and diploid tumours, and so it would seem likely that the difference in LI is due to the dilutional effect of benign tissue upon the calculation of LI in diploid tumours. The total labelling index, duration of S-phase and potential doubling time were not related to the tumour factors examined (site, T The general approach to measuring cell kinetics is to identify a 'window' in the cell cycle and measure the movement of a particular cohort of cells through this window. BrdU, an analogue of thymidine, is incorporated into cells during the S-phase of the cell cycle. BrdU is non-toxic and non-radioactive and can be given intravenously to human patients. Infusions of BrdU at higher dosage can be tolerated for several weeks without severe myelosuppression (Mitchell et al., 1983;Kinsella et al., 1984) and there have been no reports of toxic reactions in any patients receiving BrdU at 200 mg m2. It is taken up by the tumour, and the proportion of cells that have taken up BrdU can be detected using monoclonal antibodies. Furthermore, a pulse label of BrdU can be given approximately 6 h before biopsy or excision of the tumour, allowing the length of S-phase to be calculated (Begg et al., 1985). The simultaneous measurement of BrdU and DNA content using flow cytometry enables several cell kinetic parameters to be quantified. We have previously reported upon the cell kinetic results in 82 tumours and demonstrated their reproducibility (Forster et al., 1992).In this study we present further cell kinetic data on 105 patients with squamous cell tumours of the head and neck and investigate the relationship to tumour stage, site and prognosis.

Nomogram for deciding adjuvant treatment after surgery for oral cavity squamous cell carcinoma

“…Advanced neck nodal stage is also known to increase the likelihood of locoregional recurrence from OCSCC. 32 The nomogram confirmed the importance of node status for LRFS after treatment of OCSCC. Patients with advanced nodal classification (>N1) were most likely to have reduced LRFS ( Figure 2 and Table 2).…”

Molecular markers as prognostic factors for local recurrence and radioresistance in head and neck squamous cell carcinoma

“…These studies benefited from relatively long follow-up times-36 months in Bourhis's study and 37 months in Hoyer's-and large sample sizes. Cooke et al [108] also reported no significant association between overall survival and cell kinetics. The importance of Cooke's results is questionable, however, because of the short follow-up time (11 months), the heterogeneity of treatment, and the inclusion of recurrent tumors in this cohort.…”

Evaluation of Metastatic Lymph Nodes in Head and Neck Cancer: A Comparative Study Between Palpation, Ultrasonography, Ultrasound-Guided Fine Needle Aspiration Cytology and Computed Tomography

“…A retrospective study of 914 patients who underwent cervical lymph node dissection as a component of initial therapy for oral cavity, oropharyngeal, hypopharyngeal and laryngeal squamous cell carcinoma has shown that the number of positive nodes was a signifi cant, independent predictor of survival (5). The importance of positive cervical lymph nodes has been confi rmed in several other studies and appears to correlate with risk for regional recurrence as well as with risk for distant metastases (5)(6)(7)(8)(9)(10). An accurate detection of lymph node metastases in the neck has implications on therapeutic approaches.…”