Kartik Vasan1,2, Tsu-Hui Hubert Low2,3, Ruta Gupta3,4, Bruce Ashford5,6,7,8, Rebecca Asher2, Kan Gao2, Sydney Ch'ng2,3, Carsten E Palme2,3, Jonathan R Clark1,2,3,9. 1. Nepean Blue Mountains Local Health District, Sydney, Australia. 2. Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia. 3. Central Clinical School, University of Sydney, Sydney, Australia. 4. Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia. 5. School of Biological Sciences, University of Wollongong, Wollongong, Australia. 6. Illawarra Health and Medical Research Institute (IHMRI), Wollongong, Australia. 7. Illawarra and Shoalhaven Local Health District (ISLHD), Wollongong, Australia. 8. Centre for Oncology Education and Research Translation (CONCERT), Liverpool, Australia. 9. South West Clinical School, University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND: The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC. METHODS: A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold. RESULTS: Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P = .01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis. CONCLUSION: The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.
BACKGROUND: The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC. METHODS: A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold. RESULTS: Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P = .01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis. CONCLUSION: The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.
Authors: Bram van Leer; Alet J G Leus; Boukje A C van Dijk; Marloes S van Kester; Gyorgy B Halmos; Gilles F H Diercks; Bert van der Vegt; Jeroen Vister; Emoke Rácz; Boudewijn E C Plaat Journal: Front Oncol Date: 2022-05-30 Impact factor: 5.738
Authors: Axel Sahovaler; Rohin J Krishnan; David H Yeh; Qi Zhou; David Palma; Kevin Fung; John Yoo; Anthony Nichols; S Danielle MacNeil Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-04-01 Impact factor: 6.223
Authors: Joshua Lubov; Mathilde Labbé; Krystelle Sioufi; Grégoire B Morand; Michael P Hier; Manish Khanna; Khalil Sultanem; Alex M Mlynarek Journal: J Otolaryngol Head Neck Surg Date: 2021-09-07