The prognostic importance of volume-weighted mean nuclear volume, mitotic index, and other stereologically measured quantitative parameters in supraglottic laryngeal carcinoma

BACKGROUND. Stereologically measured mean nuclear volume has been proven to have prognostic importance in several types of cancer, such as malignant m elanoma and carcinomas of the breast, oral region, bladder, and uterine cer vix. The main purpose of the current study was to investigate the possible prognostic importance of mean nuclear volume and mitotic index in carcinoma of the supraglottic larynx. METHODS. The study was performed with a stratified, random sample of 113 pa tients from a well-defined group of 386 patients with supraglottic laryngea l carcinoma treated with radiotherapy at the Finsen Institute in Copenhagen . Histologic sections from pretreatment biopsies were used to estimate the following parameters: mean nuclear volume ((V) over bar v(\((3) over bar)(0 ))), mitotic index (MI), number of nuclei per mm(2) (QA), mean nuclear prof ile area (Anuc), and the area fraction of nuclei in cancer tissue (AA). The geometric means of the parameters were used as cutoff points in a single f actor and in a multivariate survival analysis with relapse free survival as the primary endpoint. RESULTS. The geometric means of the measured parameters were ((V) over bar v(\((3) over bar)(0))) = 480 mu(3), QA = 3630 nuclei/mu(2) cancer tissue, M I = 0.48 mitosis/100 nuclei, APL = 0.21, and Anuc = 57.9 mu(2) CONCLUSIONS, None of the stereologically estimated parameters proved to hav e prognostic importance, whereas tumor size, and lymph node status did. The method of adaptive, stratified, random sampling used in this study can sav e a great deal of work and is highly recommended by the authors. (C) 1999 A merican Cancer Society.