SEDIMENTATION-RATE AND SERUM THYMIDINE KINASE-ACTIVITY - PROGNOSTIC FACTORS IN SQUAMOUS-CELL HEAD AND NECK-CANCER

Identification of prognostic factors in squamous cell head and neck ca ncers involves analysis of highly diverse clinical and biological para meters. This study analyzed the prognostic value of clinical variables (age, sex, tumor site, stage) and biologic parameters (squamous cell carcinoma antigen [SCC], serum thymidine kinase activity [TK], fibrin, sedimentation rate [SR]) at the time of diagnosis of squamous cell ca rcinoma of the head and neck (oral cavity, oropharynx, hypopharynx) in 189 patients. Among the clinical variables investigated, UICC stage I II-IV disease (p < .0002), a hypopharyngeal site (p < .02), and age ov er 60 years (p < .01) were all associated with a poor prognosis. Simil arly, analysis of biological blood variables allowed definition of cut -off values above which the prognosis was poor: SCC 2.5 ng/mL (p < .01 ), fibrin 3.5 g/L (p < .01), TK 7 IU/L (p < .0005), and SR 15 mm per f irst hour (p < .0000). Cox regression analysis of overall survival ide ntified the UICC stage (p < .000), the SR (p < .001), and serum TK (p < .02) as the main independent prognostic factors. A separate study on a small number of head and neck cancer patients revealed higher TK le vels in malignant squamous cell carcinoma tissue than in adjacent heal thy tissue. (C) 1993 John Wiley & Sons, Inc.