RESUMO
A material comprising 118 laryngectomy specimens, prepared by whole organ serial sectioning, was analyzed to determine the prognostic significance of histopathological tumor grading. No statistically significant association could be demonstrated between grading and a number of clinical and histopathological variables, including pathological staging, lymph node metastases or recurrence rate. The study supports the contention that the prognostic value of histopathological grading of laryngeal squamous cell carcinoma remains uncertain and unproven. Serial sections of the whole organ, processed by routine laboratory techniques, remain important for studying tumor extension but do not contribute to establishing histopathological grading as a significant prognostic parameter.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/patologia , Laringectomia , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/cirurgia , Diferenciação Celular , Humanos , Queratinas/metabolismo , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/cirurgia , Metástase Linfática , Prognóstico , RecidivaRESUMO
Whole organ sections of laryngectomy specimens, collected over a 10-year period (1976-1985) from 118 patients with carcinoma of the larynx, were reviewed. The aim of the investigation was to compare the histopathological data with the rate of recurrence to evaluate which factors were most significant in predicting recurrence. Epitome chi2 analysis of frequency tables using corrected Yates' values revealed significant association between the recurrence rate and the depth of tumor infiltration, the presence of tumor cells at the surgical margins and the pathological TNM (tumor, nodes, metastases) stage. Multiple regression analysis identified perineural and thyroid gland tumor infiltration, anatomical location of the primary tumor and depth of tumor infiltration as independent predictors of recurrence. The greater the number of poor prognostic factors, the higher the risk for recurrence. Exact histopathological investigations integrated with clinical examinations and close patient follow-up are important and should be supported by statistical analysis to give a prognostic basis for the selection and evaluation of the treatment.