Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival.
Otolaryngol Head Neck Surg. 2016 May 24;
Authors: Imre A, Pinar E, Dincer E, Ozkul Y, Aslan H, Songu M, Tatar B, Onur I, Ozturkcan S, Aladag I
Abstract
OBJECTIVE: We investigated the value of lymph node density (LND) as a predictor of survival in patients with laryngeal squamous cell carcinoma (SCC) and positive neck node (pN+) after laryngectomy.
STUDY DESIGN: Case series with chart review.
SETTING: Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
SUBJECTS AND METHODS: We reviewed the records of 289 patients with newly diagnosed primary laryngeal carcinomas who underwent partial or total laryngectomy and combined neck dissection at a tertiary referral center between June 2006 and December 2014. Patients with pN+ laryngeal SCC (n = 101) were included in the study. Overall survival (OS) and disease-free survival (DFS) were used to evaluate the prognostic significance of LND.
RESULTS: In 101 patients with pN+ laryngeal SCC, LND ≥0.09 and number of metastatic lymph nodes >4 were significantly associated with OS and DFS but not the overall tumor, node, and metastasis stage. Forward stepwise Cox regression analysis revealed that LND ≥0.09 was the only independent predictor of both DFS and OS. Furthermore, the odds ratio of LND ≥0.09 was 10 times higher in patients with regional recurrence when compared patients without regional recurrence.
CONCLUSIONS: LND was the only independent prognostic predictor of OS and DFS in patients with pN+ laryngeal SCC. Moreover, patients with LND ≥0.09 were significantly associated with high risk of regional recurrence. Thus, patients with LND ≥0.09 are at high risk of regional recurrence and death and may be considered for adjuvant chemoradiation.
PMID: 27221573 [PubMed - as supplied by publisher]
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