Histologically negative specimens after induction therapy: Frequency and impact on survival

Background. Occasionally in head and neck cancer patients treated surgically after induction chemotherapy, the histologic analysis of the excised tissue does not show evidence of viable tumor cells, a situation that the authors named 'negative specimen.' The objective of this study was to quantify the frequency of negative specimens in surgery after induction chemotherapy and to analyze the repercussions of this situation. Methods. A retrospective study of prospectively collected data on 245 patients treated surgically after induction chemotherapy was made to calculate the frequency of negative specimens. An individualized review of the patients with negative specimens was made. The actuarial survival was calculated in relation to the existence of residual tumor. Results. Twenty-five patients (10%) had negative specimens. Five-year adjusted survival for patients with negative specimens was 96%, significantly better than 62% survival in patients with residual tumor. Conclusions. Ten percent of patients treated surgically after induction chemotherapy had no residual tumor. These patients had a favorable prognosis. (C) 2000 John Wiley and Sons, Inc.