Specific growth rates calculated from CTs in patients with head and neck squamous cell carcinoma: a retrospective study performed in Austria

BMJ Open. 2019 Feb 19;9(2):e025359. doi: 10.1136/bmjopen-2018-025359.

Abstract

Objective: To provide data on specific growth rates (SGRs) of primary tumours (PT-SGR) and largest pathological cervical lymph nodes (LN-SGR) for head and neck squamous cell carcinoma (HNSCC). To explore PT-SGR's and LN-SGR's correlation with selected biomarkers epidermal growth factor receptor (EGFR), Ki67 and CD44.

Design and setting: Retrospective study performed at a tertiary oncological referral centre in Innsbruck, Austria.

Participants: Adult patients with incident HNSCC treated with primary radiotherapy (RT) or radiochemotherapy (RCT).

Outcome measures: Volumes of the primary tumour (PT-volume) and largest pathological cervical lymph node (LN-volume) were measured in CT scans obtained at time of diagnosis and subsequent planning CTs immediately prior to RT or RCT. SGRs were calculated assuming an exponential growth function. PT-SGR's and LN-SGR's correlation with EGFR, Ki67 and CD44 were explored.

Results: In 123 patients, mean interval between diagnostic and planning CT was 29±21 days. PT-SGR was 1.8±1.8% (mean±SD) per day and was positively correlated with EGFR, Ki67 and CD44 expression (p=0.02; p=0.02; p=0.03). LN-SGR was 1.7±2.0% per day and increased with larger initial LN-volume, was lower in laryngeal cancer (p=0.003) and slowed down with time. LN-SGR was not correlated with EGFR, Ki67 or CD44 expression in primary tumours (p>0.12). New cartilage or bone infiltration occurred in 10 patients and new central lymph node necrosis in 8 patients.

Conclusions: HNSCCs are fast-growing tumours for which treatment must not be delayed. Clinical tumour growth rates are influences by EGFR, KI67 and CD44 expression.

Keywords: Cd44; Egfr; Ki67; head and neck squamous cell carcinoma; tumour growth rate; tumour volume.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Austria
  • Biomarkers, Tumor / metabolism*
  • Chemoradiotherapy
  • ErbB Receptors / metabolism
  • Female
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Hyaluronan Receptors / metabolism
  • Ki-67 Antigen / metabolism
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / diagnostic imaging
  • Squamous Cell Carcinoma of Head and Neck / pathology*
  • Tomography, X-Ray Computed*
  • Tumor Burden*

Substances

  • Biomarkers, Tumor
  • CD44 protein, human
  • Hyaluronan Receptors
  • Ki-67 Antigen
  • MKI67 protein, human
  • EGFR protein, human
  • ErbB Receptors