Histologic tumor regression grades in squamous cell carcinoma of the head and neck after preoperative radiochemotherapy

✍ Scribed by O. M. Braun; B. Neumeister; W. Popp; R. Scherrer; E. Dobrowsky; W. Dobrowsky; E. M. Rausch; H. Strassl; K. Krisch; J. H. Holzner

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 435 KB
• Volume: 63
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19890315)63:6<1097::aid-cncr2820630610>3.0.co;2-6

✦ Synopsis

Forty-one patients with Stage 111 and IV squamous cell carcinomas (SCC) of the head and neck were treated preoperatively with mitomycin C and 5-fluorouracil and concomitant radiotherapy. Operation specimen were examined histologically, the percentage of vital tumor cells and devitalized tumor cells were graduated. The grade of regression was classified according to a four-stage scale. Tumor regression was evaluated as good (Grades 1, 2) and bad (3, 4) response to combined preoperative therapy. After a follow-up of 18 to 30 months, 14 of 41 patients have experienced a locoregional recurrence; all these patients were bad responders (Grades 3,4) to preoperative radiochemotherapy. There was a statistically significant correlation between tumor regression grade and probability of survival (P -= 0.001). The authors conclude that the prognosis of patients with pretreated SCC of head and neck depends on the histologic grade of tumor regression.

Cancer 63:1097-1100, 1989.

ULTIMODALITY TREATMENT in advanced head and M neck squamous cell carcinoma (SCC) is widely ac-~epted.*-~ Partial or even complete regression of SCC of the head and neck can be achieved by preoperative continued radiochemotherapy. A combination known to be very effective is mitomycin C, 5-fluorouracil, and irradiation.

Preoperative radiochemotherapy in SCC of head and neck often shows a positive response but low complete response rates by clinical examination.'" There is no other way to determine the positive effect of pretreatment than by operation and histologic examination of operative specimen.

This study describes the technical proceeding of histologic examination of pretreated and resected SCC of head and neck, presents a scale of morphologically evaluated tumor regression grade, and reports the first results of this interdisciplinary study.