Lymph node ratio predicts survival in hypopharyngeal cancer with positive lymph node metastasis

Abstract

The lymph node density (LND) has been reported to be a significant prognostic factor in various types of carcinoma. This study investigated whether the LND is associated with survival in patients with hypopharyngeal squamous cell carcinoma (HPSCC) who have positive lymph nodes without distant metastasis. Forty-six patients who were pathologically diagnosed with HPSCC with positive lymph nodes and without distant metastasis were enrolled in this study. The LND was defined as the ratio of positive lymph nodes to the total number of lymph nodes. An LND of ≥0.09 was found to be significantly correlated with a shorter overall (p = 0.044) and disease-specific (p = 0.019) survival according to a log-rank test. In a multivariate survival analysis using a Cox proportional hazards model adjusted for the pathological T category (pT3-4/pT1-2), pathological N category (pN2/pN1) and positive surgical margin and/or extracapsular spread (presence/absence), both an LND of ≥0.09 and pT3-4 category were associated with significantly shorter overall survival (p < 0.01) and disease-specific survival (p < 0.01). These results suggest that the LND functions as a prognostic factor for HPSCC patients with positive lymph nodes who do not have distant metastasis.

Lymph node density in papillary thyroid carcinoma is a prognostic factor after adjusting for pathological stage

“…The LND, which is influenced by nodal staging, surgical, and pathological factors, has been shown to be a prognostic factor in many types of carcinoma, regardless of the types of neck dissection that are used [ 5 ]. Because the LND was reported to be affected by the number of lymph nodes retrieved based on the extent of surgery [ 7 ], we analyzed about patients with N1b rather than N1, despite on the UICC8th.…”

“…The pathological stage (pStage) in the eighth edition of Union for International Cancer Control TNM classification of Malignant Tumors (UICC8th) was expected to be a better prognostic factor for many types of carcinoma, and significant associations were found between the survival outcomes and the stage when restaging based on the UICC8th was performed for oropharyngeal carcinoma and PTC [ 1 – 4 ]. However, it was difficult to predict OS and DSS using the same TNM stage [ 5 , 6 ].…”

“…The lymph node density (LND), which is defined as the ratio of the number of positive lymph nodes to the number of total lymph nodes, has been shown to be associated with the survival outcomes in many types of carcinoma, including head and neck carcinoma [ 1 , 5 – 9 ]. In a review and several articles of PTC, the LND was also shown to be a significant prognostic factor for the survival outcomes [ 1 , 7 – 9 ].…”

Prognostic value of lymph node ratio in head and neck squamous cell carcinoma

“…The 28 studies included are listed in Table . The results are categorized per subsite of the head and neck when possible.…”

“…The results are categorized per subsite of the head and neck when possible. Nine studies were included on cancer of the oral cavity, 9 on cancer of multiple sites of the head and neck, 4 on cancer of the hypopharynx, 2 on cancer of the larynx, 1 on cancer of the oral cavity and larynx, 1 on cancer of the oropharynx, 1 on cancer of the tongue, and 1 on cancer of an unknown primary tumor . As analysis of LNR is not meaningful in cases of pN0, as it is zero, or in patients with a pN3 neck classification, as it often implies an inseparable conglomerate of metastatically involved lymph nodes, pN0 and pN3 cases were excluded from the LNR analysis.…”