Mehmet Metin Yildiz1, Iver Petersen2, Ekkehard Eigendorff3, Peter Schlattmann4, Orlando Guntinas-Lichius5. 1. Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany. 2. Institute of Pathology, Jena University Hospital, Jena, Germany. 3. University Tumor Center, Jena University Hospital, Jena, Germany. 4. Department of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany. 5. Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany. orlando.guntinas@med.uni-jena.de.
Abstract
PURPOSE: To investigate the best lymph node (LN) metastasis predictor for overall survival (OS) in head neck cancer (HNC): pN classification, number of positive lymph nodes (PNOD), lymph node ratio (LNR), or log odds of positive lymph nodes (LODDS). METHODS: In total, 225 surgically treated HNC patients were evaluated for the different LN classifications and OS. RESULTS: Five-year OS was 71.8 %. Mean number of yielded LN and PNOD was 25.3 ± 16.7 and 2.7 ± 5.9, respectively. 64.8 % had a LNR > 0.10 and 64.4 % a LODDS > 10. In univariable analysis, multimodal therapy (p = 0.039), advanced pT (p < 0.0001), advanced UICC stage (p = 0.029), LNR > 0.10 (p = 0.049), and LODDS > -1.0 (p = 0.021) were associated with lower OS. In multivariable analysis, advanced pT [hazard ratio (HR) 2.194; 95 % confidence interval (CI) 1.294-3.722; p = 0.004] and LODDS > -1.0 (HR 1.634; 95 % CI 1.002-2.665; p = 0.059) remained independent predictors for lower OS. CONCLUSIONS: It seems useful to analyze the prognostic significance of LODDS in other samples of HNC.
PURPOSE: To investigate the best lymph node (LN) metastasis predictor for overall survival (OS) in head neck cancer (HNC): pN classification, number of positive lymph nodes (PNOD), lymph node ratio (LNR), or log odds of positive lymph nodes (LODDS). METHODS: In total, 225 surgically treated HNC patients were evaluated for the different LN classifications and OS. RESULTS: Five-year OS was 71.8 %. Mean number of yielded LN and PNOD was 25.3 ± 16.7 and 2.7 ± 5.9, respectively. 64.8 % had a LNR > 0.10 and 64.4 % a LODDS > 10. In univariable analysis, multimodal therapy (p = 0.039), advanced pT (p < 0.0001), advanced UICC stage (p = 0.029), LNR > 0.10 (p = 0.049), and LODDS > -1.0 (p = 0.021) were associated with lower OS. In multivariable analysis, advanced pT [hazard ratio (HR) 2.194; 95 % confidence interval (CI) 1.294-3.722; p = 0.004] and LODDS > -1.0 (HR 1.634; 95 % CI 1.002-2.665; p = 0.059) remained independent predictors for lower OS. CONCLUSIONS: It seems useful to analyze the prognostic significance of LODDS in other samples of HNC.
Entities:
Keywords:
Cancer staging; Head and neck neoplasm; Lymph nodes; Lymphatic metastasis; Neck dissection; Survival
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