OXYGENATION OF SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK - COMPARISON OF PRIMARY TUMORS, NECK NODE METASTASES, AND NORMAL TISSUE

Background: Most previous oxygenation measurements of head and neck tu mors have mainly been performed in neck nodes. We investigated, theref ore, the relationship between the pO(2) status of primary tumors, cerv ical neck node metastases and normal tissues. Patients and Methods: 30 patients with histologically proven advanced stage HI-IV squamous cel l carcinoma of head and neck underwent pretreatment polarographic pO(2 ) measurements with a pO(2) histograph (Eppendorf, Hamburg, Germany). We obtained data on oxygenation of 23 primary tumors, of 22 neck node metastases, and of 30 contralateral sternocleidomastoid muscles. In 15 cases,,ve were able to perform measurements in all three regions in t he same individual. results: A highly significant correlation existed between the median pO(2) of primary tumors and their neck node metasta ses (p = 0.0001), as well as between the proportion of pO(2) values le ss than or equal to 2.5 mmHg and less than or equal to 5.0 mmHg (p = 0 .0001, p = 0.001) in both anatomic sites. The average pretreatment med ian pO(2) was 14.7 mmHg (range 0.2-58.5 mmHg) in primary tumors, 13.7 mmHg (range 1.9-50.3 mmHg) in neck node metastases, and 43.8 mmHg (ran ge 20.8-67.7 mmHg) in sternocleidomastoid muscles. In all cases, the o xygenation of malignant tissue,vas below that of the corresponding mus cle. There was also a weak, but significant, correlation between hemog lobin level and the median pO(2) of the primary tumors, as well as bet ween hemoglobin concentration and the proportion of values below 5 mmH g at the primary site (p = 0.017, p = 0.003). Conclusions: Primary tum ors and their regional lymph node metastases in advanced squamous cell carcinoma of the head and neck show comparable patterns of oxygenatio n in terms of the median pO(2) and the proportion of hypoxic measureme nts. This report suggests that, in patients,vith such carcinomas, the oxygenation data obtained at one site are related to tumor oxygenation at other sites, so that measurements in any anatomic site would he su fficient to estimate a tumor's oxygenation status. The weak correlatio n between pO(2) and hemoglobin level requires further investigation. ( C) 1998 Elsevier Science Inc.