Yeonjoo Choi1, Manal Bin-Manie1,2, Jong-Lyel Roh3, Kyung-Ja Cho4, Yoon Se Lee1, Seung-Ho Choi1, Soon Yuhl Nam1, Sang Yoon Kim1. 1. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. 2. Department of Otolaryngology Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia. 3. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. rohjl@amc.seoul.kr. 4. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Abstract
PURPOSE: Metastatic lymph node (LN) burden is one of the most important prognosticators in human solid cancers, but has rarely been examined in laryngeal and hypopharyngeal cancers (LHC). We evaluated the nodal factors predictive of recurrence and survival in patients with LHC. METHODS: This study included 141 consecutive patients who underwent primary surgery and neck dissection for previously untreated LHC at our tertiary referral centre. Nodal factors included the presence of pathological LN metastasis, number of positive LNs, LN ratio, and extra-nodal extension (ENE). Our proposed N classification was analysed by recursive partitioning analysis and compared with the AJCC and other N classifications using the c-index. Univariate and multivariate Cox proportional hazard regression analyses were used to define significant predictors of post-treatment disease-free survival (DFS) and overall survival (OS). RESULTS: Of the 141 patients, 66 (46.8%) had positive LNs, and 27 (19.1%) had ENE. In multivariate analyses, the number of positive LNs was strongly associated with DFS and OS outcomes (P < 0.01). Our new N classification was proposed with four categories, such as N0 (0 LN +), N1 (1 LN +), N2 (2-4 LN + or ENE) and N3 (≥ 5 LN +). The C-index of our new N classification improved the OS prediction (0.718) compared with the AJCC and the other N classifications (0.704-0.713). CONCLUSION: Metastatic LN burden is an important predictor of survival in patients with LHC. A proposed N classification using the number of positive LNs and ENE might improve the LHC survival prediction.
PURPOSE: Metastatic lymph node (LN) burden is one of the most important prognosticators in humansolid cancers, but has rarely been examined in laryngeal and hypopharyngeal cancers (LHC). We evaluated the nodal factors predictive of recurrence and survival in patients with LHC. METHODS: This study included 141 consecutive patients who underwent primary surgery and neck dissection for previously untreated LHC at our tertiary referral centre. Nodal factors included the presence of pathological LN metastasis, number of positive LNs, LN ratio, and extra-nodal extension (ENE). Our proposed N classification was analysed by recursive partitioning analysis and compared with the AJCC and other N classifications using the c-index. Univariate and multivariate Cox proportional hazard regression analyses were used to define significant predictors of post-treatment disease-free survival (DFS) and overall survival (OS). RESULTS: Of the 141 patients, 66 (46.8%) had positive LNs, and 27 (19.1%) had ENE. In multivariate analyses, the number of positive LNs was strongly associated with DFS and OS outcomes (P < 0.01). Our new N classification was proposed with four categories, such as N0 (0 LN +), N1 (1 LN +), N2 (2-4 LN + or ENE) and N3 (≥ 5 LN +). The C-index of our new N classification improved the OS prediction (0.718) compared with the AJCC and the other N classifications (0.704-0.713). CONCLUSION: Metastatic LN burden is an important predictor of survival in patients with LHC. A proposed N classification using the number of positive LNs and ENE might improve the LHC survival prediction.
Entities:
Keywords:
Laryngohypopharyngeal cancer; Lymph node; Metastatic burden; N classification; Survival
Authors: Soon-Hyun Ahn; Hyun Jun Hong; Soon Young Kwon; Kee Hwan Kwon; Jong-Lyel Roh; Junsun Ryu; Jun Hee Park; Seung-Kuk Baek; Guk Haeng Lee; Sei Young Lee; Jin Choon Lee; Man Ki Chung; Young Hoon Joo; Yong Bae Ji; Jeong Hun Hah; Minsu Kwon; Young Min Park; Chang Myeon Song; Sung-Chan Shin; Chang Hwan Ryu; Doh Young Lee; Young Chan Lee; Jae Won Chang; Ha Min Jeong; Jae-Keun Cho; Wonjae Cha; Byung Joon Chun; Ik Joon Choi; Hyo Geun Choi; Kang Dae Lee Journal: Clin Exp Otorhinolaryngol Date: 2017-01-03 Impact factor: 3.372
Authors: Ardalan Ebrahimi; Ziv Gil; Moran Amit; Tzu-Chen Yen; Chun-Ta Liao; Pankaj Chaturvedi; Jai Prakash Agarwal; Luiz P Kowalski; Hugo F Kohler; Matthias Kreppel; Claudio R Cernea; Jose Brandao; Gideon Bachar; Andrea Bolzoni Villaret; Dan Fliss; Eran Fridman; K Thomas Robbins; Jatin P Shah; Snehal G Patel; Jonathan R Clark Journal: Cancer Date: 2014-04-01 Impact factor: 6.860
Authors: Vasu Divi; Jonathan Harris; Paul M Harari; Jay S Cooper; Jonathan McHugh; Diana Bell; Erich M Sturgis; Anthony J Cmelak; Mohan Suntharalingam; David Raben; Harold Kim; Sharon A Spencer; George E Laramore; Andy Trotti; Robert L Foote; Christopher Schultz; Wade L Thorstad; Qiang Ed Zhang; Quynh Thu Le; F Christopher Holsinger Journal: Cancer Date: 2016-07-15 Impact factor: 6.860
Authors: Vasu Divi; Michelle M Chen; Brian Nussenbaum; Kim F Rhoads; Davud B Sirjani; F Christopher Holsinger; Jennifer L Shah; Wendy Hara Journal: J Clin Oncol Date: 2016-11-10 Impact factor: 44.544
Authors: Smith Apisarnthanarax; Danielle D Elliott; Adel K El-Naggar; Joshua A Asper; Angel Blanco; K Kian Ang; Adam S Garden; William H Morrison; David Rosenthal; Randal S Weber; K S Clifford Chao Journal: Int J Radiat Oncol Biol Phys Date: 2005-10-21 Impact factor: 7.038
Authors: A Dimitrios Colevas; Sue S Yom; David G Pfister; Sharon Spencer; David Adelstein; Douglas Adkins; David M Brizel; Barbara Burtness; Paul M Busse; Jimmy J Caudell; Anthony J Cmelak; David W Eisele; Moon Fenton; Robert L Foote; Jill Gilbert; Maura L Gillison; Robert I Haddad; Wesley L Hicks; Ying J Hitchcock; Antonio Jimeno; Debra Leizman; Ellie Maghami; Loren K Mell; Bharat B Mittal; Harlan A Pinto; John A Ridge; James Rocco; Cristina P Rodriguez; Jatin P Shah; Randal S Weber; Matthew Witek; Frank Worden; Weining Zhen; Jennifer L Burns; Susan D Darlow Journal: J Natl Compr Canc Netw Date: 2018-05 Impact factor: 11.908
Authors: Ahmad A AlTuwaijri; Mohammed A Alessa; Alanoud A Abuhaimed; Reenad H Bedaiwi; Mohammad A Almayouf; Majed M Albarrak; Saleh F Aldhahri; Khalid H Al-Qahtani Journal: Saudi Med J Date: 2021-12 Impact factor: 1.422
Authors: Ke Wang; Xia Xu; Ruotao Xiao; Danyi Du; Luqi Wang; Hanqing Zhang; Zehong Lv; Xiangping Li; Gang Li Journal: J Int Med Res Date: 2021-12 Impact factor: 1.671