Prognostic assessment of sonography and tumor volumetry in advanced cancer of the head and neck by use of doppler ultrasonography.
OBJECTIVE
The objective of this trial was to examine the degree of tumor vascularity in lymph node metastases as depicted by computer-assisted color Doppler sonography and the tumor volumes associated with prognosis in carcinomas of the oropharynx and hypopharynx after primary radiochemotherapy.


METHODS
In a prospective trial, 25 patients with advanced squamous cell carcinomas of the oropharynx and hypopharynx (stage IV UICC 1997) were treated with radiochemotherapy. The color Doppler findings were quantified with a computer-assisted protocol that quantitatively describes color Doppler images by the relative color pixel density (CPD). As important prognostic cofactor, total tumor volume (TTV) was calculated from CT sections and related to the degree of vascularity.


RESULTS
Low CPD in neck metastases showed a correlation with better overall survival. A high-CPD group and a high-TTV group (median survival 10.1 months) were determined and were compared with all other CPD/TTV combinations (median survival 28.4 months); the difference in survival was significant (P = 0.002).


CONCLUSIONS
The results indicate that high tumor vascularity in combination with high TTV indicates a particularly bad prognosis in patients treated with primary radiochemotherapy for head and neck cancer.
Dietz
A
A
Department of Otolaryngology-Head and Neck Surgery, the Department of Radiation Oncology, and the Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
Delorme
S
S
Rudat
V
V
Zuna
I
I
Conradt
C
C
Vanselow
B
B
Weidauer
H
H
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D007013:Hypopharynx; D008875:Middle Aged; D009960:Oropharynx; D010610:Pharyngeal Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D018608:Ultrasonography, Doppler