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Uni- and multivariate analysis of eight indications for postoperative radiotherapy and their significance for local-regional cure in advanced head and neck cancer

Published online by Cambridge University Press:  29 June 2007

L. A. Ravasz ,
G. J. Hordijk ,
P. J. Slootweg ,
F. Smit  and
I. V. D. Tweel
L. A. Ravasz
Affiliation:
Department of Radiotherapy, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
G. J. Hordijk*
Affiliation:
Department of Ear, Nose and Throat Surgery, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
P. J. Slootweg
Affiliation:
Department of Pathology, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
F. Smit
Affiliation:
Department of Radiotherapy, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
I. V. D. Tweel
Affiliation:
Department of Radiotherapy, University Hospital Utrecht, and the Centre of Biostatistics, University of Utrecht.
*
G. J. Hordijk, M.D., Department of Ear, Nose and Throat Surgery, University Hospital Utrecht, Heidelberglaan 100, 3548 CX Utrecht, The Netherlands.
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Abstract

Eighty consecutive patients with advanced head and neck cancer were treated with combined therapy of radical surgery and post-operative radiotherapy. Indications for post-operative radiotherapy were pathological staging of the primary tumour (pT3 or pT4), poorly differentiated or undifferentiated carcinoma (G3, G4), tumour thickness, tumour invasion in the surrounding tissues with slender tumour strands and solitary tumour cells, perineural spread, lymphangio-invasive tumour growth, multiple positive neck nodes or extranodal spread, and microscopical irradicality of the surgical margins. The contribution for prognosis of these indications for post-operative radiotherapy were retrospectively calculated in an univariate and multivariateanalysis. Of all investigated parameters, the mode of tumour invasion and lymphangio-invasive growth were independent prognostic factors. If these unfavourable prognostic signs are present, post-operative radiotherapy has to be intensified to at least curative doses of 66 Gy or more to the areas at risk.

Keywords

Head and neck neoplasmsRadiotherapySurgeryPrognosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 5 , May 1993 , pp. 437 - 440
Copyright
Copyright © JLO (1984) Limited 1993

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References

Amdur, R. J., Parsons, J. T., Mendenhall, W. M., Million, R. R., Stringer, S. P., Cassisi, N. J. (1989) Post-operative irradiation for squamous cell carcinoma of the head and neck: analysis of treatment results and complications. International Journal of Radiation, Oncology, Biology and Physiology 16: 25–36CrossRefGoogle Scholar
Arriagada, R., Eschwege, E., Cachin, Y., Richard, J. M. (1983) The value of combining radiotherapy with surgery in the treatment of hypopharyngeal and laryngeal cancers. Cancer 51: 1819–18253.0.CO;2-G>CrossRefGoogle ScholarPubMed
Chen, T. Y., Emrich, L. J., Driscoll, D. L. (1987) The clinical significance of pathological findings in surgically resected margins of the primary tumour in head and neck carcinoma. International Journal of Radiation, Oncology, Biology and Physiology 13: 833–837CrossRefGoogle ScholarPubMed
Crissman, J. D., Liu, W. Y., Gluckman, J. L., Cummings, G. (1984) Prognostic value of histopathologic parameters in squamous cell carcinoma of the oropharynx. Cancer 54: 2995–30013.0.CO;2-R>CrossRefGoogle ScholarPubMed
Fletcher, G. H. (1984) Subclinical disease (Lucy Wortham James Lecture). Cancer 53: 1274–12843.0.CO;2-U>CrossRefGoogle ScholarPubMed
Franchin, G., De Paoli, A., Gobitti, C, Boz, G., Minatel, E., Roncadin, M., Arcicasa, M., Bortulus, R., Innocente, R., Trovo, G. M. (1989) Post-operative radiotherapy in locally advanced head and neck cancer. Tumori 75: 47–52CrossRefGoogle Scholar
Geoffray, B., Luboinsky, B., Wibault, P., Micheau, C, Richard, J. M. (1987) Combined treatment of cancer of the posterior oral cavity and oropharynx. Clinical Otolaryngology 12: 429–439CrossRefGoogle ScholarPubMed
Jakobsson, P. A., Eneroth, G. M., Kollander, D., Moeberger, G., Martensson, B. (1973) A histological classification and grading of malignancy in carcinoma of the larynx. Acta Radiologica 12: 1–8Google ScholarPubMed
Kramer, S., Gelber, R. D., Snow, J. B., Marcial, V. A., Lowry, L. D., Davis, L. W., Chandler, R. (1987) Combined radiation therapy and surgery in the management of advanced head and neck cancer: final report of study 73–03 of the radiation therapy oncology group. Head and Neck Surgery 10: 19–30CrossRefGoogle ScholarPubMed
Lewis, L. J., Lavey, R. S., Groshen, S., Prosnitz, L. R. (1989) Postoperative radiation therapy of upper aerodigestive tract cancers with positive surgical margins: Prognostic factors. International Journal of Radiation, Oncology, Biology and Physiology 17: 230.CrossRefGoogle Scholar
Looser, K. G., Shah, J. P., Strong, E. W. (1978) The significance of ‘positive’ margins in surgically resected epidermoid carcinomas. Head and Neck Surgery 1: 107–111CrossRefGoogle ScholarPubMed
Mantravadi, R. V. P., Skolnik, E. M., Haas, R. E., Applebaum, E. L. (1983) Patterns of cancer recurrence in the post-operatively irradiated neck. Archives of Otolaryngology 109: 753–756CrossRefGoogle Scholar
Mantravadi, R. V. P., Skolnik, E. M., Applebaum, E. L. (1981) Complications of post-operative and preoperative radiation therapy in head and neck cancers. A comparative study. Archives of Otolaryngology 107: 690–693CrossRefGoogle Scholar
McGravan, M. H., Bauer, W. C, Ogura, J. H. (1961) The incidence of cervical lymph node metastases from epidermoid carcinoma of the larynx and their relationship to certain characteristics of the primary tumour. Cancer 14: 55–663.0.CO;2-2>CrossRefGoogle Scholar
Nathanson, A., Agren, K., Biorklund, A., Lind, M. G., Andreason, L., Anniko, M., Freijd, A., Lejdeborn, L., Kinman, S., Kumlien, A., Koling, A., Lindstrom, J., Novik, A., Olofsson, J., Petterson, K. I. (1989) Evaluation of some prognostic factors in small squamous cell carcinoma of the mobile tongue: a multicentre study in Sweden. Head and Neck Surgery 11: 387–392Google Scholar
Platz, H., Fries, R., Hudec, M., Tjoa, A. M., Wagner, R. R. (1983) The prognostic relevance of various factors at the time of the first admission of the patient. Journal of Maxillofacial Surgery 11: 3–12CrossRefGoogle ScholarPubMed
Snow, J. B., Gelber, R. D., Kramer, S., Davis, L. W., Marcial, V. A., Lowry, L. D. (1980) Randomized preoperative radiation therapy for patients with carcinoma of the head and neck. Laryngoscope 90: 930–945CrossRefGoogle ScholarPubMed
Snow, G. B., Annyas, A. A., van Slooten, E. A., Bartelink, H., Hart, A. A. M. (1982) Prognostic factors of neck node metastasis. Clinical Otolaryngology 7: 185–192CrossRefGoogle ScholarPubMed
Spiro, R. H., Huvos, A. G., Wong, G. Y., Spiro, J. D., Gnecco, C. A., Strong, E. W. (1986) Predictive value of tumour thickness in squamous carcinoma confined to the tongue and floor of the mouth. American Journal of Surgery 152: 345–350CrossRefGoogle Scholar
Stell, P. M. (1990) Prognosis in laryngeal carcinoma: tumour factors. Clinical Otolaryngology 15: 69–81CrossRefGoogle ScholarPubMed
Urist, M. M., O'Brien, C. J., Soong, S. J., Visscher, D. W, Maddox, W. A. (1987) Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. American Journal of Surgery 154: 411–414CrossRefGoogle ScholarPubMed
Van den, Bogaert W., Ostyn, F., Lemkens, P., van den Schueren, E. (1984) Are post-operative complications more frequent and more serious after irradiation for laryngeal and hypopharyngeal cancer? Radiotherapy and Oncology 2: 31–36CrossRefGoogle Scholar
Vandenbrouck, C., Sancho, H., Le Fur, R., Richard, J. M., Cachin, Y. (1977) Results of a randomized clinical trial of preoperative irradiation versus post-operative treatment of tumours of the hypopharynx. Cancer 39: 1445–14493.0.CO;2-6>CrossRefGoogle Scholar
Yamamoto, E., Miyakawa, A., Kohama, G. (1984) Mode of invasion and lymph node metastasis in squamous cell carcinoma of the oral cavity. Head and Neck Surgery 6: 938–947CrossRefGoogle ScholarPubMed