Prognostic factors in squamous cell neoplasias of the upper aero-digestive tract

In addition to the TNM-staging, tumor thickness and location of metastases have prognostic value. Extracapsular lymph-node spread is, however, the single most important prognostic factor in head and neck cancer. Tumour differentiation, malignancy grading, field cancerization and risk of multiple primaries are other factors that have to be taken into account. DNA diploid tumors often do better than DNA aneuploid tumors. Aneuploid tumors, however, respond better to radiotherapy than diploid ones. Increased expression of EGFR may influence the rate of recurrence of squamous cell carcinoma which we found for both glottic and maxillary sinus carcinomas. Overexpression of EGFR seems to be associated with a shorter survival in patients with oral cavity cancer. Differing results are reported when looking at overexpression of p53, PCNA, and ki67. We found a positive correlation between TNM-stage and immunohistochemical staining with p53, PCNA and Ki67, in a series of 120 laryngeal cancers. We also had a positive correlation in staining intensity between p53, ki67 and PCNA. There was a strong correlation between these markers in proliferative activity and the degree of aggressiveness of the tumor in patients with laryngeal cancer. Factors such as the density of Langerhans cells, tumor angiogenesis, apoptosis AgNOR and enzymes as glutathione S-transferases are relevant.