Cell proliferation activity and kinetic profile in the prognosis and therapeutic management of carcinoma of the pharynx and larynx

Prognosis and management of carcinoma of the pharynx and larynx is now base d on the morphologic analysis of the tumor spreading, differentiation gradi ng, and type of microscopic invasion. The DNA ploidy status and the cell pr oliferation activity analyzed by flow cytometry give us complementary infor mation about the prognosis and the management and support of the patients. We performed a study of 91 cases of carcinoma of the larynx and pharynx by means of flow cytometry Forty-three patients were treated by surgery alone, and 48 patients also received radiotherapy. Fifty-five were aneuploid (60% ); this percentage increased to 74% in the pharynx area and fell to 47% at the larynx level. The aneuploid tumors showed worse behavior in the patient s treated by surgery alone compared with those who also received radiothera py. The S-phase fraction was high in aneuploid tumors, in positive lymph no des, and in advanced stages. The S-phase fraction was higher in poorly diff erentiated tumors. In patients treated by surgery alone, we noticed that by combining both cytometric variables two different kinetic profiles could b e defined related to the patients' behavior. The diploid tumors with a low S phase had the greatest rates of survival, whereas diploid tumors with a h igh rate of S phase and aneuploids had a lower rate.