DNA content and histologic growth pattern correlate with prognosis in patients with advanced squamous cell carcinoma of the larynx. The Department of Veterans Affairs Cooperative Laryngeal Cancer Study Group.
BACKGROUND
Alterations in DNA content, nuclear morphologic characteristics, and histologic grading have been associated with prognosis in several types of solid malignant neoplasms.


METHODS
To determine the potential usefulness of these factors in predicting tumor behavior in patients with laryngeal squamous cell carcinoma, tumor specimens from 88 previously untreated patients with Stage III or IV cancers were studied. The DNA content and nuclear area (NA) were measured for individual nuclei of each tumor with the use of Azure A-stained frozen sections. An adjusted DNA index (aDI) for each patient was calculated from the slope of the linear regression analysis of nuclear DNA index on NA. Hematoxylin and eosinstained sections were examined and graded systematically for histologic growth pattern. All patients were enrolled in a prospective clinical trial and had laryngectomy and postoperative radiation therapy.


RESULTS
The disease-free survival length was longer and the relapse rates were lower in patients with a low aDI (P less than 0.005) and with tumors exhibiting low-grade growth patterns (P less than 0.001).


CONCLUSIONS
These parameters were independent of staging variables and were better predictors of tumor relapse than traditional clinical staging classifications.
Truelson
J M
JM
Department of Otolaryngology, University of Michigan, Ann Arbor.
Fisher
S G
SG
Beals
T E
TE
McClatchey
K D
KD
Wolf
G T
GT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure; D002455:Cell Division / Q000502:physiology; D002467:Cell Nucleus / Q000473:pathology; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis
D004273:DNA, Neoplasm