| Genetically altered fields as origin of locally recurrent head and neck cancer: a retrospective study. | |
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MedLine Citation:
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PMID: 15173066 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Surgeons treating patients with head and neck squamous cell carcinoma (HNSCC) rely heavily on histology to decide whether the resection margins are tumor free and subsequent adjuvant treatments can be omitted. However, despite the presence of tumor-free margins, 10-30% of HNSCC patients still develop a locally recurrent tumor. Evidence is available that recurrent cancer develops from either (a). outgrowth of a relatively small number of tumor cells that have not been detected by the pathologist or (b). a precursor lesion in which additional genetic alterations have led again to invasive cancer. EXPERIMENTAL DESIGN: In a retrospective study on 13 HNSCC cases, we analyzed the primary tumor, its surrounding histologically tumor-free resection margins, and local recurrences for loss of heterozygosity (22 microsatellite markers on 6 chromosomes) and TP53 mutations to determine the origin of the recurrent cancer. RESULTS: A precursor lesion was absent in 5 of 13 (39%) cases, and the genetic similarity of the primary and recurrent cancer was high, providing evidence that residual cancer cells were the origin of recurrence. For the remaining eight cases (61%) a genetically related precursor lesion (field) was detected, and for five of these cases, evidence was found that both the primary and recurrent carcinoma originated from this field. The remaining three cases were less conclusive. CONCLUSIONS: This study explains the pathobiology of locally recurrent HNSCC in patients with histologically tumor-free resection margins and indicates that the development of novel therapies to decrease the local recurrence rates in HNSCC should not only be focused on eradicating residual cancer cells but also on the precursor lesions that are left behind. |
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Authors:
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Maarten P Tabor; Ruud H Brakenhoff; Henrique J Ruijter-Schippers; J Alain Kummer; C René Leemans; Boudewijn J M Braakhuis |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical cancer research : an official journal of the American Association for Cancer Research Volume: 10 ISSN: 1078-0432 ISO Abbreviation: Clin. Cancer Res. Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-06-02 Completed Date: 2004-12-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9502500 Medline TA: Clin Cancer Res Country: United States |
Other Details:
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Languages: eng Pagination: 3607-13 Citation Subset: IM |
Affiliation:
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Departments of Otolaryngology/Head-Neck Surgery and Pathology, VU University Medical Center, Amsterdam, the Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Carcinoma, Squamous Cell / genetics*, pathology* Female Genes, p53 Head and Neck Neoplasms / genetics*, pathology* Humans Loss of Heterozygosity Male Microsatellite Repeats Middle Aged Mutation Neoplasm Recurrence, Local Neoplasm, Residual Recurrence Retrospective Studies Treatment Outcome |
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