DNA-PLOIDY IN NONMELANOMA SKIN-CANCER

BACKGROUND. Patients with head and neck squamous cell carcinoma die of locoregional recurrence and those with basal cell carcinoma suffer co smetic and functional changes from its treatment. Prognostic factors a re based upon tumor characteristics and host factors. Flow cytometry c an assist with prognostic characterization of nonmelanoma skin cancer. METHODS. Specimens from 40 sequential patients with head and neck non melanoma skin cancers were prospectively obtained at the time of surge ry. The patients were followed for four years for local recurrence and metastasis to regional lymph nodes. Samples were prepared from frozen specimens using a modification of the Vindelov procedure. RESULTS. DN A aneuploidy or tetraploidy and histology of well differentiated squam ous cell carcinoma were significantly associated with metastasis to re gional lymph nodes. Direct extension of tumor below the adipose tissue was associated with an S-phase greater than 4.1 and a proliferative f raction greater than 5.5, No tumors recurred at the site of surgical r esection. CONCLUSIONS. The measurement of DNA ploidy of well different iated squamous cell carcinoma, and proliferative capacity or S-phase o f both basal cell and squamous cell carcinomas assists in predicting t he biologic proclivity for locoregional invasion or metastasis of nonm elanoma skin cancer. Identification of aggressive tumors at the time o f surgery may offer the opportunity for prevention of lethal metastasi s by using adjunctive therapy. Cancer 1996; 77:284-91. (C) 1996 Americ an Cancer Society.