Immunologic assessment of regional lymph node histology in relation to survival in head and neck carcinoma

Histologic material from 84 cases of squamous cell carcinoma of head and neck regions was studied by double blind retrospective analysis. Sections of lymph nodes draining the tumors were examined microscopically to assess the morphologic pattern of response. Patients whose lymph nodes demonstrated active immunologic responses in the form of expanded inner cortices or increased numbers of germinal centers had 5-year survival rates significantly greater than those patients whose regional lymph nodes showed an unstimulated pattern. None of the patients whose lymph nodes showed the depleted pattern survived 5 years. These correlations were independent of the stage or grade of the tumor. Metastases occurred much more frequently in patients having regional nodes showing an unstimulated or depleted pattern than in those whose regional nodes showed evidence of immunologic activity. The data support the concept of a relationship between immunologic activity, progression of neoplasia, and survival. Morphologic assessment of immunologic activity in lymph nodes draining malignant tumors appear to be of significant value in the predicting survival.