Prognostic significance of keratinization in XXXX .

@entity1 @entity5 @entity957 @entity189 @entity1544 @entity3 @entity204
INTRODUCTION: Keratinization may be a vulnerable aid in predicting response to therapy for @entity189 . METHODS: The presence or absence of keratin in biopsy specimens was correlated with @entity5 behavior, locoregional control, patterns of failure, and survival of @entity1 irradiated for @entity189 . RESULTS: @entity1 with keratinizing @entity1544 (World Health Organization [WHO] type 1) had a higher incidence (76%) of locally advanced @entity5 than those with nonkeratinizing (WHO type 2) and undifferentiated (WHO type 3) @entity5 (55%). The former group of @entity1 had a lower incidence (29%) of lymph node @entity3 than the later group (70%). @entity5 was controlled in 62% and neck nodes were controlled in 82% of all @entity1 . @entity5 control rates were 29% in @entity1 with keratinizing @entity1544 and 79% in those with nonkeratinizing and undifferentiated @entity5 (P = .001). Nodal control rates were 76% for keratinizing squamous-cell @entity5 and 85% for nonkeratinizing and undifferentiated @entity5 (P = .001). The incidence of distant @entity3 was 6% in @entity1 with keratinizing squamous-cell @entity5 and 33% in those with nonkeratinizing and undifferentiated @entity5 (P = .001). @entity1 with keratinizing @entity1544 , even though they had a lower incidence of lymphatic and distant @entity3 , had a poorer survival rate because of a higher incidence of @entity204 from uncontrolled @entity5 and nodal @entity3 . The 5-year survival rates were 35% for all @entity1 , 6% for those with keratinizing @entity1544 , and 51% for nonkeratinizing and undifferentiated @entity5 respectively (P = .001). CONCLUSION: Higher doses of external beam radiotherapy with or without brachytherapy boost may be needed to improve local control and survival of @entity1 with keratinizing @entity957 of the nasopharynx, whereas an effective systemic therapy is needed for nonkeratinizing and undifferentiated @entity5 , which tend to metastasize.
