European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 11, pp 2391–2399

Evaluation of overall tumor cellularity after neoadjuvant chemotherapy in patient with locally advanced hypopharyngeal cancer

  • Shun-ichi Chitose
  • Hideki Chijiwa
  • Akiteru Maeda
  • Hirohito Umeno
  • Tadashi Nakashima
  • Kensuke Kiyokawa
  • Naofumi Hayabuchi
  • Hiromasa Fujita
Head and Neck

DOI: 10.1007/s00405-011-1915-1

Cite this article as:
Chitose, S., Chijiwa, H., Maeda, A. et al. Eur Arch Otorhinolaryngol (2012) 269: 2391. doi:10.1007/s00405-011-1915-1

Abstract

The aim of this study is to clarify the prognostic value of the pathological overall tumor cellularity after neoadjuvant chemotherapy for locally advanced hypopharyngeal cancer. In consecutive series of 45 operable patients with locally advanced hypopharyngeal cancer, neoadjuvant chemotherapy by cisplatin and 5-fluorouracil was administered. Pathological image analysis was performed in 30 patients using the large cross-section specimen after total resection to evaluate the overall tumor cellularity. The chemotherapeutic responses were classified according to the pathological grading scale by dividing into four categories; more than 70% overall tumor cellularity in Grade 1, between an estimated 10 and 70% in Grade 2, less than 10% in Grade 3, and no identifiable malignant tumor cells in Grade 4. The pathological grades were taken into account for analysis of the survival. In 30 available patients, 40% had Grade 1 pathological response, 30% had Grade 2, and 30% had Grade 3. There was no Grade 4 patient. The overall 5-year survival rate for these 30 patients was 53.33%. The survival rate (61.66%) for patients with Grade 2 and 3 responses was significantly higher than that (27.78%) for patients with Grade 1 response (p = 0.009). Cox regression analysis revealed that the increasing pathological grade was an independent predictor of a better survival in patients undergoing neoadjuvant chemotherapy. We have shown that the prognosis of patients with locally advanced hypopharyngeal cancer, who had been treated by neoadjuvant chemotherapy followed by total resection, can be predicted by evaluation of pathological overall tumor cellularity from the large section specimen.

Keywords

Neoadjuvant chemotherapy Hypopharyngeal cancer Overall tumor cellularity Large cross section Image analysis 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Shun-ichi Chitose
    • 1
  • Hideki Chijiwa
    • 1
  • Akiteru Maeda
    • 1
  • Hirohito Umeno
    • 1
  • Tadashi Nakashima
    • 1
  • Kensuke Kiyokawa
    • 2
  • Naofumi Hayabuchi
    • 3
  • Hiromasa Fujita
    • 4
  1. 1.Department of Otolaryngology, Head and Neck SurgeryKurume University School of MedicineKurumeJapan
  2. 2.Department of Plastic and Reconstruction Surgery and Maxillo-Facial SurgeryKurume University School of MedicineKurumeJapan
  3. 3.Department of RadiologyKurume University School of MedicineKurumeJapan
  4. 4.Department of SurgeryKurume University School of MedicineKurumeJapan

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