Histopathologic findings after cis-platinum bleomycin therapy in advanced previously untreated head and neck carcinoma

Shapshay, Stanley M.; Hong, Waun Ki; Incze, Joseph S.; Yamaguchi, Kent T.; Bhutani, Rakesh; Vaughan, Charles W.; Strong, M. Stuart

doi:10.1016/0002-9610(78)90277-5

Cited by 34 publications

(6 citation statements)

References 8 publications

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“… 10 , 11 In human clinical studies, increased keratinization of affected cancer cells is the common histological finding, but death of cancer cells has rarely been mentioned. 10 , 12 , 13 Based on the results of this study, we could support the sequential events occurring in OSCC treated by chemotherapy reported in a previous study. 9 The OSCC cells evolve through 2 stages in response to chemotherapy, an early phase of necrosis and degeneration of cancer cells, and a late phase of squamous and keratinizing metaplasia of cancer cells.…”

Section: Discussionsupporting

confidence: 85%

Comparisons of histological features among primary oral squamous cell carcinomas before and after adjuvant chemotherapy and their lymph node metastatic cancer lesions after adjuvant chemotherapy

Cheng

Wang

et al. 2022

Journal of Dental Sciences

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Background/purpose Adjuvant chemotherapy has been used to control the primary oral squamous cell carcinoma (OSCC) size prior to surgical excision of the cancer. This study aimed to explore the histological changes of primary OSCCs and their cervical lymph node metastatic cancer lesions after chemotherapy. Materials and methods Thirty-three OSCC patients with eleven having cervical lymph node metastases received adjuvant chemotherapy before surgical excision of their cancer lesions. Hematoxylin and eosin-stained tissue sections of incisional biopsy, surgical excision, and cervical lymph node metastatic cancer lesion specimens were compared microscopically to observe the histological changes in the cancer tissues after chemotherapy. Results Common histological features could be found in the primary OSCCs and their cervical lymph node metastatic cancer lesions after chemotherapy. These included direct killing of cancer cells by chemotherapeutic agents, resulting in cancer cell necrosis and degeneration in the early phase, and squamous and keratinizing metaplasia of drug-induced cancer cells, leading to individual cell keratinization and keratin pearl formation in the later phase. There were also small nests of drug-resistant proliferating cancer cells in the inflamed fibrous connective tissue stroma. The most characteristic histological feature in the metastatic lymph nodes after chemotherapy was the keratinizing metaplasia of the metastatic cancer cells, resulting in the formation of epidermoid cyst-like lesions. Conclusion Although the cancer reduces its size after chemotherapy, residual cancer cells are consistently present in the primary OSCC lesions after chemotherapy. Therefore, wide surgical resection of the cancer is still needed to ensure the complete removal of all cancer tissues.

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Section: Discussionsupporting

confidence: 85%

Comparisons of histological features among primary oral squamous cell carcinomas before and after adjuvant chemotherapy and their lymph node metastatic cancer lesions after adjuvant chemotherapy

Cheng

Wang

et al. 2022

Journal of Dental Sciences

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“…,~' investigating the effect of BLM on squamous carcinoma, amve at the same conclusion. Michael's results are in accordance with a recent finding that BLM fails to induce keratinization in a mouse teratoma cell line.42 BLM combined with CDDP seems to produce more extensive keratinization of head and neck cancer than BLM alone 43. Several other tumor types have been reported to show differentiation upon administration of chemotherapy, irradiation, or both: ganglioneuroblastoma and neuro-DIFFERENTIATION O F NONSEMINOMA METASTASES AFTER CHEMOTHER…”

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confidence: 88%

Effects of multiple-drug chemotherapy (cis-diammine-dichloroplatinum, bleomycin, and vinblastine) on the maturation of retroperitoneal lymph node metastases of nonseminomatous germ cell tumors of the testis: No evidence for de novo induction of differentiation

Oosterhuis

Suurmeyer

Sleyfer

et al. 1983

Cancer

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Investigating the mechanisms underlying maturation of metastases of nonseminomatous germ cell tumors on administration, of chemotherapy, the histologic characteristics of primary testis tumors was compared to the histologic characteristics of their retroperitoneal metastases in three historical patient groups. The metastases in Group I (20 patients) were not treated; those in Groups II (nine patients) and III (24 patients) were treated, respectively, with three cycles of dactinomycin and with four cycles of cis‐diammine‐dichloroplatinum, vinblastine, and bleomycin, before retroperitoneal lymph node dissection. In Group III there was a significant increase of metastases consisting of differentiated teratoma only, as compared to the metastases of Group I. However, both with and without chemotherapy, the metastases contained fewer areas of differentiated teratoma than the primary lesions. Metastases containing differentiated teratoma with and without other components, with one exception in Group III, were derived from primary tumors containing mature areas as well. Components other than mature teratoma were almost completely eradicated in Group III. These findings strongly suggest that selective destruction of components other than differentiated teratoma causes the mature histologic characteristics in the metastases upon administration of chemotherapy. The results do not support the hypothesis of induction of differentiation by the chemotherapeutic agents.

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“…21 Yet, we are aware of only a few I5.17. 18 dealing with a detailed pathologic examination of surgical specimens resected after induction IV or intraarterial chemotherapy (IAC) for these carcinomas. In evaluating preoperative chemotherapy for head and neck carcinoma^,^'-^^ most reports offer an insufficient description of the pathologic examinations performed to determine the presence of residual cancer.…”

mentioning

confidence: 99%

A pathologic assessment of tumor residue and stromal changes after intraarterial chemotherapy for head and neck carcinomas. A study on serial sections of the whole surgical specimen

Sulfaro

Frustaci

Volpe

et al. 1989

Cancer

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Thirty-one patients with advanced, biopsy-proven squamous cell carcinoma (SCC) of the head and neck were treated with intraarterial chemotherapy (IAC) and subsequent radical surgery. Cisplatin at 25 mg/d (4 hours of infusion) and bleomycin at 15 mg/d (20 hours of infusion) were administered for 10 consecutive days. Radical surgery was performed after clinical evaluation 2 weeks later. Clinical tumor regression (total disappearance or shrinkage of the tumor mass by more than 50%) was recorded in 28 of 31 (90.3%) patients. Tumor regression was then assessed pathologically using a procedure based on examination of large serial histologic sections of the whole surgical specimen. Tumor residue was classified pathologically according to the TNM categories: RO, no residual tumor (five cases [16.1%]); R1, microscopic residual tumor (tumor residue detectable only at the microscopic level; 12 cases [38.7%]); and R2, macroscopic residual tumor (tumor mass detectable also on the fresh or fixed specimen and/or by the naked eye on the stained tissue sections; 14 cases [45.2%]). Moreover, tumor cell and/or stromal changes possibly associated with tumor regression were found in 77.4% of the cases. Metastatic lymph nodes were found in 12 cases (38.7%), and regression changes were observed in most lymph node metastases. Only standardized, prospective pathologic protocols for the analysis of whole specimens by serial sections permit the assessment of existing tumor residue. The TNM classification of pathologic tumor residue and definitions that we used appear feasible and reliable enough in evaluating postchemotherapeutic tumor regression.

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Histopathologic findings after cis-platinum bleomycin therapy in advanced previously untreated head and neck carcinoma

Cited by 34 publications

References 8 publications

Comparisons of histological features among primary oral squamous cell carcinomas before and after adjuvant chemotherapy and their lymph node metastatic cancer lesions after adjuvant chemotherapy

Comparisons of histological features among primary oral squamous cell carcinomas before and after adjuvant chemotherapy and their lymph node metastatic cancer lesions after adjuvant chemotherapy

Effects of multiple-drug chemotherapy (cis-diammine-dichloroplatinum, bleomycin, and vinblastine) on the maturation of retroperitoneal lymph node metastases of nonseminomatous germ cell tumors of the testis: No evidence for de novo induction of differentiation

A pathologic assessment of tumor residue and stromal changes after intraarterial chemotherapy for head and neck carcinomas. A study on serial sections of the whole surgical specimen

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