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

Abstract

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.

Keywords

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

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

Abstract

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.

Keywords

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

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