Lenf Nodu Pozitif Baş-Boyun Kanserli Hastalarda Sağ Kalımı Öngören Lenf Nodu Oranı

Yıl 2022, , 26 - 31, 22.04.2022

Mustafa Korkmaz , Melek Karakurt Eryılmaz , Mustafa Karaağaç Mehmet Artaç

https://doi.org/10.46332/aemj.811295

Öz

Amaç: Lenf nodu oranı (LNR), pozitif lenf nodlarının toplam eksize edilmiş lenf nodlarına oranını temsil eder. Baş ve boyun SCC'si nedeniyle cerrahi yapılmış hastalarda LNR ile sağkalım arasındaki ilişki değerlendirildi.
Araçlar ve Yöntem: Çalışmaya cerrahi rezeksiyon ve boyun diseksiyonu yapılan baş ve boyun skuamöz hücreli karsinomlu 33 hasta dahil edildi. Kaplan-Meier analizi ve log-rank testi, hastalıksız sağkalım (DFS) ve genel sağ kalımdaki (OS) farklılıkları karşılaştırmak için kullanıldı.
Bulgular: Ortalama LNR değeri 0.1, ortalama yaş 57, 28 erkek ve 5 kadın hasta dahil edildi. Medyan DFS 10.4 aydı ve medyan OS 32.5 aydı. Kaplan-Meier sağkalım analizi ile DFS ve OS karşılaştırıldığında, medyan LNR≥0.1 olan hastaların, oranları bu eşik değerlerin altında olan hastalara göre anlamlı derecede daha kötü DFS (p:0.029) ve OS (p:0.036) olduğunu bulduk. Diğer bilinen rekürrens ve sağkalım prediktörleri göz önüne alındığında, LNR'nin DFS (p=0.036, HR 0.38, % 95 CI 0.15-0.93) ve OS (p=0.042, HR 0.40% 95 CI 0.17-0.96) ile anlamlı şekilde ilişkili olduğu bulundu.
Sonuç: Çalışmamız, yüksek LNR'nin baş-boyun kanserli hastalarda sağkalım için bağımsız bir prediktörü olduğunu gösterdi. Baş-boyun kanserli hastalarda LNR, rekürrens ve sağkalımı tahmin etmek için ek bir parametre olarak kullanılabilir.

Anahtar Kelimeler

lenf nodu oranı, baş-boyun kanseri, lenf nodu pozitif, rekürrens, sağkalım

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Lymph Node Ratio Predictive of Survival in Node-Positive Head and Neck Cancer

Öz

Purpose: Lymph node ratio (LNR) represents the ratio of positive lymph nodes to total excised lymph nodes. We analyzed the correlation between LNR and outcomes in patients who have undergone surgery for SCC of the head and neck.
Materials and Methods: Thirty-three patients with head and neck squamous cell carcinoma (HNSCC) who underwent surgical resection and neck dissection were included. Kaplan-Meier analysis and log-rank test were used to compare differences in disease-free survival (DFS) and overall survival (OS).
Results: In total, 28 males and 5 females with a median of age 57 years were identified, with a median recorded LNR of 0.1. The median DFS was 10.4 months, and the median OS was 32.5 months. When DFS and OS were compared by Kaplan-Meier survival analysis, we found that patients with the median LNR≥0.1 had significantly worse DFS (p:0.029) and OS (p:0.036) than patients with ratios below these threshold values. Considering other known predictors of recurrence and survival, we found that LNR was significantly associated with DFS (p=0.036, HR 0.38, 95% CI 0.15-0.93) and OS (p=0.042, HR 0.40, 95% CI 0.17-0.96).
Conclusion: Our study showed that high LNR was an independent predictor of outcome in patients with HNSCC. In HNSCC, LNR can be used as an additional parameter to predict recurrence and survival.

Anahtar Kelimeler

lymph node ratio, head and neck cancer, lymph node positive, recurrence, survival

Proje Numarası

yok

Kaynakça

• 1. Cerezo L, Millan I, Torre A, et al. Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer. A multivariate study of 492 cases. Cancer. 1992;69(5):1224-1234.
• 2. Amin MB, Greene FL, Edge SB, et al. The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67(2):93-99.
• 3. Chow LQM. Head and Neck Cancer. N Engl J Med. 2020;382(1):60-72.
• 4. Vasan K, Low TH, Gupta R, et al. Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma. Head Neck. 2018;40(5):993-999.
• 5. Chen CC, Lin JC, Chen KW. Lymph node ratio as a prognostic factor in head and neck cancer patients. Radiat Oncol. 2015;10(1):1-6.
• 6. Braakhuis BJ, Brakenhoff RH, Leemans CR. Treatment choice for locally advanced head and neck cancers on the basis of risk factors: biological risk factors. Ann Oncol. 2012;23(10):173-177.
• 7. Bernier J, Domenge C, Ozsahin M, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med. 2004;350(19):1945-1952.
• 8. Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg. 1994;168(5):494-498.
• 9. Pignon JP, le Maître A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92(1):94.
• 10. Ampil FL, Caldito G, Ghali GE. Can the lymph node ratio predict outcome in head and neck cancer with single metastasis positive-node? Oral Oncol. 2014;50(4):18-20.
• 11. Yildiz MM, Petersen I, Eigendorff E et al. Which is the most suitable lymph node predictor for overall survival after primary surgery of head and neck cancer: pN, the number or the ratio of positive lymph nodes, or log odds? J Cancer Res Clin Oncol. 2016;142(4):885-893.
• 12. Abdeyrim, A., He, S., Zhang, Y. et al. Prognostic value of lymph node ratio in laryngeal and hypopharyngeal squamous cell carcinoma: a systematic review and meta-analysis. J of Otolaryngol - Head & Neck Surg. 2020;49(1):31.
• 13. Wang YL, Li DS, Wang Y, Wang ZY, Ji QH. Lymph node ratio for postoperative staging of laryngeal squamous cell carcinoma with lymph node metastasis. PLoS One. 2014;9(1):e87037.
• 14. Mizrachi A, Hadar T, Rabinovics N, et al. Prognostic significance of nodal ratio in cutaneous squamous cell carcinoma of the head and neck. Eur Arch Otorhinolaryngol. 2013;270(2):647-653.
• 15. Tseros EA, Gebski V, Morgan GJ, Veness MJ. Prognostic Significance of Lymph Node Ratio in Metastatic Cutaneous Squamous Cell Carcinoma of the Head and Neck. Ann Surg Oncol. 2016;23(5):1693-1698.
• 16. Vasan K, Low TH, Gupta R. et al. Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma. Head Neck. 2018;40(5):993-999.
• 17. Prabhu RS, Hanasoge S, Magliocca KR et al. Lymph node ratio influence on risk of head and neck cancer locoregional recurrence after initial surgical resection: implications for adjuvant therapy. Head Neck. 2015;37(6):777-782.
• 18. Hua YH, Hu QY, Piao YF, Tand Q, Fu ZF. Effect of number and ratio of positive lymph nodes in hypopharyngeal cancer. Head Neck. 2015;37(1):111-116.
• 19. Shrime MG, Bachar G, Lea J, et al. Nodal ratio as an independent predictor of survival in squamous cell carcinoma of the oral cavity. Head Neck. 2009;31(11):1482-1488.