Clinical and Histologic Predictive Factors of Response to Induction Chemotherapy in Head and Neck Squamous Cell Carcinoma.
OBJECTIVE
Induction chemotherapy (IC) is occasionally used in head and neck cancer, leading to less extensive surgery and reduced need for irradiation. Factors predicting the response to IC have not been determined. In this study, we investigated the clinical and histopathologic factors that predict the response to IC.


METHODS
Head and neck squamous cell carcinomas from 81 patients were analyzed; clinical factors, histologic parameters, and expression of p16 and p53 were correlated with response to chemotherapy and prognosis.


RESULTS
Factors predicting a good response to IC were the nonoropharyngeal localization, a rich lymphocytic tissue response, and a low platelet-to-lymphocyte blood ratio before treatment. Response to IC did not correlate with prognosis, whereas a low neutrophil-to-lymphocyte ratio (NLR), the absence of a desmoplastic reaction, a rich lymphocytic tissue response, and the overexpression of p53 were associated with better prognosis.


CONCLUSIONS
Lymphocytic tissue response, NLR, and nonoropharyngeal localization are factors predictive of response to IC.
From the Department of Pathology.
Georgia
G
Karpathiou
Department of Head and Neck Surgery.
Jean-Baptiste
JB
Giroult
From the Department of Pathology.
Fabien
F
Forest
Oncology Institute Lucien Neuwirth, St-Étienne, France.
Pierre
P
Fournel
From the Department of Pathology.
Alessandra
A
Monaya
Department of Pneumonology, North Hospital, University Hospital of St-Étienne, St-Étienne, France; and.
Marios
M
Froudarakis
From the Department of Pathology.
Jean Marc
JM
Dumollard
Department of Head and Neck Surgery.
Jean Michel
JM
Prades
Department of Head and Neck Surgery.
Marie
M
Gavid
From the Department of Pathology.
Michel
M
Peoc'h
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005602:France; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D006801:Humans; D060828:Induction Chemotherapy; D008214:Lymphocytes / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D043823:Taxoids / Q000008:administration & dosage; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D043823:Taxoids; D016159:Tumor Suppressor Protein p53; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
Blood count; Fibroblastic; Histology; Histoprognosis; Immunohistochemistry; Localization; Lymphocytes; NLR; PLR; Prognosis