title: Prognostic value of S-phase fraction in head and neck squamous cell carcinomas and nodal negative breast carcinomas.
abstract: OBJECTIVE
  The prognostic value of proliferative activity (percentage of S-phase cells = SPF) was determined in head and neck and nodal negative breast carcinomas and correlated with treatment outcome and analysis of recurrence.
  
  
  METHODS
  SPF of 171 primary squamous cell carcinomas of the head and neck and 183 nodal negative breast carcinomas was determined by one-dimensional flow cytometry.
  
  
  RESULTS
  For the whole population of head and neck carcinomas slowly proliferating tumors (SPF < median) had a better five-year survival rate (28%) than fast proliferating tumors (S-phase > median; 20% p < 0.05). Failure analysis revealed that the better survival of slowly proliferating tumors was due to the higher loco-regional control rate (62%) compared to fast proliferating tumors (43%; p < 0.05). Stepwise multivariate analysis revealed treatment modality (p = 0.107), SPF (p = 0.026) and UICC stage (p = 0.044) as independent prognostic factors for loco-regional recurrences and SPF (p = 0.0143) for three-year overall survival. In nodal negative breast cancer slowly proliferating tumors (SPF < median) had a better NED survival (92%) compared to fast proliferating tumors (SPF > median; NED survival 63%). The analysis of recurrence revealed a higher rate of distant metastases (15.7%) and of loco-regional recurrences (21%) for fast proliferating tumors as compared to slowly proliferating tumors (distant metastases: 1.1%; loco-regional recurrences 4.5%). Stepwise multivariate analysis showed that SPF (p = 0.001) was the only independent prognostic factor for NED survival; grading (p = 0.022), age (p = 0.003) and SPF (p = 0.007) for freedom from distant metastases; SPF (p = 0.0039), grading (p = 0.0956) and method of surgical treatment (p = 0.0715) for loco-regional recurrences.
  
  
  CONCLUSIONS
  SPF has a relevant prognostic power for squamous cell head and neck cancer and nodal negative breast cancer.
authors.affiliation: Strahlentherapeutische Klinik, Universität Erlangen-Nürnberg.
authors.forename: R
authors.initials: R
authors.lastname: Fietkau
authors.forename: H
authors.initials: H
authors.lastname: Iro
authors.forename: A H
authors.initials: AH
authors.lastname: Tulusan
authors.forename: V
authors.initials: V
authors.lastname: Dressel
authors.forename: A
authors.initials: A
authors.lastname: Altendorf-Hofmann
authors.forename: R
authors.initials: R
authors.lastname: Sauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000235:genetics* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005434:Flow Cytometry; D006258:Head and Neck Neoplasms / Q000235:genetics* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D016196:S Phase; D015996:Survival Rate