Detection of micrometastatic tumor cells in head and neck squamous cell carcinoma. A possible predictor of recurrences?

OBJECTIVES: To evaluate the presence of micrometastatic tumor cells in the peripheral blood samples of the patients with head and neck squamous cell carcinoma (HNSCC) and to determine whether the presence of micrometastatic cells had any biological relevance in terms of local recurrences or metastasis during a follow-up period of 3 years.

METHODS: We included 21 consecutive patients with untreated primary HNSCC admitted to the Ear Nose and Throat Department of Akdeniz University Medical School, Antalya, Turkey between February and October 2002. Squamous carcinoma cells in peripheral blood samples of these patients prior to surgery were detected via a magnetic cell separation technique using anti-epithelial cell adhesion molecule antibody, and thereafter evaluated by light microscopy with hematoxylin and eosin staining.

RESULTS: Seven out of 21 patients showed squamous carcinoma cells in peripheral blood samples. Patients with stage III and IV tumors were nearly 5 times more likely to show micrometastatic cells compared with those with stage I and II tumors (6/12 versus 1/9). During the follow-up, 2 patients out of 7 with micrometastasis had recurrences. None in the micrometastasis negative group relapsed.

CONCLUSIONS: We suggest that HNSCC patients with detectable tumor cells in peripheral blood represent a subset of patients who should be followed up more closely for possible recurrences.