VICC International Union Against Cancer

Union Internationale Contre Ie Cancer

Springer Berlin Heidelberg New York Barcelona Budapest Hong Kong London Milan Paris Tokyo

Prognostic Factors in Cancer

Edited by P. Hermanek, M.K. Gospodarowicz, D.E. Henson, R.Y.P. Hutter, L.H. Sobin

With 14 Figures and 60 Tables

Springer

UICC 3, rue du Conseil-Gent!ral, CH-1205 Geneva, Switzerland

Editors:

Professor Dr. Dr. h.c. P. Hermanek Vorstand der Abteilung fUr Klinische Patho1ogie i. R. Chirurgische Universitiitsklinik Erlangen Krankenhausstr. 12,91054 Erlangen, FRG

Dr. Mary K. Gospodarowicz Princess Margaret Hospital, Department of Radiation Oncology University of Toronto, 500 Sherbourne Street Toronto, Ontario M4X 1K9, Canada

Dr. D.E. Henson Early Detection Branch, Division of Cancer Prevention and Control National Cancer Institute, EPN Building, Room 305 9000 Rockville Pike, Bethesda, MD 20892, USA

Dr. R.V.P. Hutter Clinical Professor of Pathology University of Medicine and Dentistry New Jersey Medical School, Newark, NJ Department of Pathology, Saint Barnabas Medical Center Old Short Hills Road, Livingston, NJ 07039, USA

Dr. L.H. Sobin Professor of Pathology Uniformed Services University of the Health Sciences Bethesda, MD Division of Gastrointestinal Pathology Armed Forces Institute of Pathology, Washington, DC 20306, USA

Library of Congress Cataloging-in-Publication Data

Prognostic factors in cancer I edited by P. Hennanek '" let al.]. p. crn. "UICC, International Union Against Cancer - Union Internationale Contre Ie Cancer" --Po preceding t. p. Includes bibliographical references and index. ISBN-13:978-3-540-58688-3 1. Cancer--Prognosis. I. Hermanek, Paul. II. International Union against Cancer. [DNLM: 1. Neoplasms--diagnosis. 2. Prognosis. 3. Neoplasm Staging. 4. Survival Rate. QZ 241 P964 1996]

RC262.P688 1995 616.99'4075--dc20 95-19216

ISBN-13 :978-3-540-58688-3 e-ISBN -13 :978-3-642-79395-0 DOl: 10.1007/978-3-642-79395-0

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© International Union Against Cancer, Geneva 1995

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Preface·

This monograph is the result of an effort by the International Union Against Cancer (UICC) to study prognostic factors related to cancer. It is an.extension of the long-term work on the TNM classification, the most widely used "staging" classification and the strongest prognostic factor for most cancer.

Although anatomic extent of disease (TNM) is generally the most important indicator of prognosis for cancer patients and provides the main criterion for selection of therapy, anatomic extent coupled with other factors could provide an even more powerful system for prog­nostic assessment and choice of therapy.

The purpose of this monograph is to compile information on prognostic factors for most tumour sites and selected tumour types. Each site- or tumour-specific chapter provides a general overview of the relevant literature on prognostic factors. Where possible, the authors have attempted to assess these factors in terms of their strength and independence to influence prognosis and their clinical relevance.

The TNM classification, which describes the anatomic extent of disease, is the most time proven prognostic classification. As such, TNM serves as a standard against which other prognostic factors and classifications are measured.

We hope that the present compilation of prognostic factors will aid in: (l) portraying the scope of this field; (2) stimulating the study of these and other prognostic factors; and (3) bringing some perspective to those working on specific factors.

March 1995 P. Hermanek, Erlangen M.K. Gospodarowicz, Toronto D.E. Henson, Bethesda, MD R.V.P. Hutter, Livingston, NJ L.H. Sobin, Washington, DC

Acknowledgement

Reviewer

Bielach S, MD, Hamburg, Germany Diehl V, MD, Prof., Koln, Germany Dold UW, MD, Priv. Doz., Freiburg, Germany Gebhardt Ch, MD, Prof., Niirnberg, Germany Hofiken K, MD, Prof., Jena, Germany Hohenberger W, MD, Prof., Erlangen, Germany Kindermann G, MD, Prof., Miinchen, Germany Konig HJ, MD, Prof., Erlangen, Germany Laperriere NJ, MD, Toronto, Ontario, Canada Meister P, MD, Prof., Miinchen, Germany Mennel HD, MD, Prof., MarburgiLahn, Germany Payne DG, MD, Toronto, Ontario, Canada Schlag P, MD, Prof., Berlin, Germany Schrott KM, MD, Prof., Erlangen, Germany Siewert JR, MD, Prof., Miinchen, Germany Steiner W, MD, Prof., Gottingen, Germany Wigand ME, MD, Prof., Erlangen, Germany Winkler K, MD, Prof., Hamburg, Germany Wustrow TPU, MD, Prof., Miinchen, Germany

The editors have much pleasure in acknowledging the great help received from the reviewers listed above.

Contents

Introduction .................................... . M.K. Gospodarowicz, P. Hermanek, and D.E. Henson

2 Squamous Cell Carcinoma of the Head and Neck 12 E.W. Strong, H. Kasdorf, and J.M. Henk

3 Parotid Carcinoma ................................ 23 C. Calearo and A. Pastore

4 Thyroid Carcinoma ............................... 28 A. Antonaci, J. Brierley, G. Bacchi, F. Consorti, C. Consoli, A. Manzini, M. TAgliaferri, F. Ficulccilli, F. Menichelli, C. Miani, P. Miani, M. DI Paola, and M. Piemonte

5 Oesophageal Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 J.D. Roder, H.J. Stein, and J.R. Siewert

6 Stomach Carcinoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 P. Hermanek, K. Maruyama, and L.H. Sobin

7 Colorectal Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 P. Hermanek and L.H. Sobin

8 Anal Canal Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 B.J. Cummings

9 Hepatocellular Carcinoma .......................... 88 C. Wittekind

10 Carcinoma of the Gallbladder ....................... 94 M.T. Carriaga and D.E. Henson

11 Carcinoma of the Extrahepatic Bile Ducts M.T. Carriaga and D.E. Henson

100

12 Exocrine Pancreatic Carcinoma ...................... 105 M. Yamamoto, Y. Saitoh, and P. Hermanek

13 Lung Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 118 H. Asamura and T. Naruke

X Contents

14 Osteosarcoma H. Fukuma

130

15 Soft Tissue Sarcomas in Adults ...................... 138 S. Toma, W. Hohenberger, R. Palumbo, o. Schmidt, G. Nicolo, G. Canavese, and F. Badellino

16 Skin Carcinoma .................................. 149 P. Hermanek and H. Breuninger

17 Malignant Melanoma of Skin ....................... 152 P. Hermanek and N.N. Blinov

18 Breast Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 165 H.B. Burke, R.V.P. Hutter, and D.E. Henson

19 Vulvar Carcinoma ................................ 177 J.L. Benedet, D.M. Miller, E. Kovacs, and H. Ludwig

20 Cervix Uteri Carcinoma. . . . . . . . . . . . . . . . . . . . . . . . . . .. 185 A Fy1es and P. Kirkbride

21 Corpus Uteri Carcinoma ........................... 193 J.L. Benedet, T.G. Ehlen, E. Kovacs, and H. Ludwig

22 Fallopian Tube Carcinoma ......................... 203 A.C. Rosen and M.J. Klein

23 Ovarian Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 207 A Pfleiderer

24 Prostate Carcinoma ............................... 216 L.J. Denis, P.A. Catton, M.K. Gospodarowicz, G.P. Murphy, P.O. Hedlund, and F.K. Mostofi

25 Testicular Germ Cell Tumors. . . . . . . . . . . . . . . . . . . . . . .. 224 M.K. Gospodarowicz and J.F.G. Sturgeon

26 Renal Cell Carcinoma ............................. 234 M.K. Gospodarowicz and J.E. Montie

27 Urinary Bladder Carcinoma. . . . . . . . . . . . . . . . . . . . . . . .. 241 M.K. Gospodarowicz

28 Ophthalmic Tumours .............................. 249 G.K. Lang, C.W. Spraul, and G.O.H. Naumann

29 Neuroepithelial Tumours of Brain ....... . . . . . . . . . . . .. 257 K. Nomura and AB.M.F. Karim

30 Hodgkin Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 263 M.K. Gospodarowicz, L. Specht, and S.B. Sutcliffe

31 Non-Hodgkin Lymphomas ......................... 271 M.K. Gospodarowicz and M. Hayat

Subject Index ....................................... 281

List of Contributors

Antonaci, A. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Asamura, H. Division of Thoracic Surgery, Department of Surgery, National Cancer Center Hospital, I-I, Tsukiji 5-Chome, Chuo-ku, Tokyo 104, Japan

Bacchi, G. Division of Otorhinolaryngology, Ospedale Civile Regionale, 33100 Udine, Italy

Badellino, F. Division of Surgical Oncology, National Institute for Cancer Research-1ST, 10132 Genoa, Italy

Benedet, J.L. Department of Gynaecology, Vancouver General Hospital, 805 West 12th Avenue, Vancouver, BC, Canada V5Z IM9

Blinov, N.N. N.N. Petrov Research Institute of Oncology, 68 Leningradskaya St., Pesochny 2, St. Petersburg 189646, Russia

Breuninger, H. Universitatshautklinik, 72076 Tiibingen, Germany

Brierley, J. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Burke,B. Department of Medicine, New York Medical College, Valhalla, NY 10595, USA

XII List of Contributors

Calearo, C. Department of Otolaryngology, University of Ferrara, Arcispedale S. Anna, 44100 Ferrara, Italy

Canavese, G. Division of Surgical Oncology, National Institute for Cancer Research-1ST, 10132 Genoa, Italy

Carriaga, M.T. Department of Pathology, Georgetown University School of Medicine, Washington, DC 20007, USA

Catton, P .A. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Consoli,C. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Consorti, F. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Cummings, B.J. Department of Radiation Oncology, University of Toronto, Ontario Cancer InstitutelPrincess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Denis, L.J. Department of Urology, A.Z. Middelheim, 2020 Antwerp, Belgium

DiPaola, M. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Ehlen, T.G. Department of Gynaecology, Vancouver General Hospital, 805 West 12th Avenue, Vancouver, BC, Canada V5Z IM9

Ficulccilli, F. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Fukuma,H. Department of Orthopedic Surgery, National Cancer Center Hospital, 1-1, Tsukiji 5-Chome, Chuo-ku, Tokyo 104, Japan

List of Contributors XIII

Fyles, A. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Gospodarowicz, M.K. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Hayat, M. Department of Oncology, Institut Gustave Roussy, rue Camille Desmoulin, 94805 Villejuif, France

Hedlund, P.O. Department of Urology, Karolinska Hospital, 10401 Stockholm, Sweden

Henk,J.M. Royal Marsden Hospital, Sutton, Surrey SM2 5PT, UK

Henson, D.E. Early Detection Branch, Division of Cancer Prevention and Control, National Cancer Institute, EPN Building, Room 305, 9000 Rockville Pike, Bethesda, MD 20892, USA

Hermanek, P. Department of Surgical Pathology, University of Erlangen, Krankenhausstr. 12,91054 Erlangen, Germany

Hohenberger, W. Chirurgische Klinik uhd Poliklinik, University of Erlangen, Krankenhausstr. 12,91054 Erlangen, Germany

Hutter, R.V.P. St. Barnabas Medical Center, Old Short Hills Road, Livingston, NJ 07039, USA

Karim, A.B.M.F. Department of Radiation Oncology, Academisch Ziekenhuis, Vrije Universiteit, 1007 MB Amsterdam, The Netherlands

Kasdorf, H. Academia Nazional de Medicine, Montevideo 11000, Uruguay

Kirkbride, P. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Klein,M.J. Donauspital, Department of Oncology, 1200 Vienna, Austria

XIV List of Contributors

Kovacs, E. Department of Obstetrics and Gynecology, University of Basel, 4031 Basel, Switzerland

Lang,G.K. University Eye Hospital and Clinic, University ofUlm, Prittwitzstr. 43, 89075 Ulm, Germany

Ludwig,H. Department of Obstetrics and Gynecology, University of Basel, 4031 Basel, Switzerland

Manzini,A. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Maruyama, K. Division of Gastric Surgery, Department of Surgery, National Cancer Center Hospital, 1-1, Tsukiji 5-Chome, Chuo-ku, Tokyo 104, Japan

Menichelli, F. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Miani,C. Divisione of Otorhinolaryngology, Ospedale Civile Regionale, 33100 Udine, Italy

Miani, P. Divisione of Otorhinolaryngology, Ospedale Civile Regionale, 33100 Udine, Italy

Miller, D.M. Division of Gynaecologic Oncology, Vancouver General Hospital, British Columbia Cancer Agency, 805 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9

Montie, J .E. Department of Urology, Wayne State University, Harper Hospital, Detroit, MI 48201, USA

Mostofi, F.K. Department of Genitourinary Pathology, Armed Forces Institute of Pathology, Washington, DC 20306, USA

Murphy. G.P. Pacific Northwest Research Foundation, Seattle, WA 98122, USA

List of Contributors XV

Naruke, T. Division of Thoracic Surgery, Department of Surgery, National Cancer Center Hospital, 1-1, Tsukiji 5-Chome, Chuo-ku, Tokyo 104, Japan

Naumann, G.O.H. University Eye Hospital and Clinic, University of Erlangen­Nurnberg, Schwabachanlage 6, 91054 Erlangen, Germany

Nicolo, G. Service of Pathology and Cytology, National Institute for Cancer Research-1ST, 10132 Genoa, Italy

Nomura, K. Division of Surgical Oncology, National Cancer Centre Hospital, 1-1, Tsukiji 5-Chome, Chuo-ku, Tokyo 104, Japan

Palumbo,R. Department of Medical Oncology, National Institute for Cancer Research-1ST, 10132 Genoa, Italy

Pastore,A. Department of Otolaryngology, University of Ferrara, Arcispedale S. Anna, 44100 Ferrara, Italy

Pfleiderer, A. Universitatsfrauenklinik, Klinikum der Universitat, 79106 Freiburg, Germany

Piemonte, M. Division of Otorhinolaryngology, Ospedale Civile Regionale, 33100 Udine, Italy

Roder,J.D. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, TU Munchen, Ismaninger Str. 22, 81675 Munich, Germany

Rosen,A.C. Donauspital, Department of Gynaecology, 1200 Vienna, Austria

Saitoh, Y. 1st Department of Surgery, Kobe University School of Medicine, Kobe City 650, Japan

Schmidt,O. Department of Surgery, Universitatsklinikum, 93053 Regensburg, Germany

XVI List of Contributors

Siewert,J.R. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, TU Munchen, Ismaninger Str. 22, 81675 Munich, Germany

Sobin, L.H. Division of Gastroenterology, Armed Forces Institute of Pathology, Washington, DC 20306, USA

Specht, L. Department of Oncology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark

Spraul, C.W. University Eye Hospital and Clinic, University ofU1m, Prittwitzstr. 43, 89075 Ulm, Germany

Stein, H.J. Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, TU Munchen, Ismaninger Str. 22, 81675 Munich, Germany

Strong, E.W. Head and Neck Service, Memorial Sloan Kettering Cancer Centre, New York, NY 10021, USA

Sturgeon, J.F.G. Department of Medicine, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X lK9

Sutcliffe, S.B. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada M4X IK9

Tagliaferri, M. Department of Clinical Surgery IV, University "La Sapienza" di Roma, 00161 Rome, Italy

Toma, S. Department of Medical Oncology, National Institute for Cancer Research-1ST, 10132 Genoa, Italy

Wittekind, C. Institute of Pathology, Department of Surgery and Urology, Friedrich-Alexander-University Erlangen, Krankenhausstr. 12, 91054 Erlangen, Germany

Yamamoto, M. 1st Department of Surgery, Kobe University School of Medicine, Kobe City 650, Japan