Recommendation for incorporation of a different lymph node scoring system in future AJCC N category for oral cancer

Lee, Ching‐Chih; Su, Yu‐Chieh; Hung, Shih‐Kai; Chen, Po-Chun; Huang, Chung‐I; Huang, Wei‐Lun; Lin, Yu‐Wei; Yang, Ching‐Chieh

doi:10.1038/s41598-017-06452-0

Cited by 27 publications

(22 citation statements)

References 27 publications

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“…Recently, the lymph node ratio (LNR) that is the ratio of PLNs to RLNs, and log of odds between PLNs and the number of negative lymph node (LODDS) have emerged as alternative predictive factors for outcomes and showed superiority to lymph node status-based assessment in pancreatic cancer 10 , 11 , oral cancer 12 , 13 , non-small cell lung cancer 13 ,colorectal cancer 14 , ovarian cancer 15 , breast cancer 16 . LNR was also studied in ovarian cancer and found to be superior to both PLN and RLN in predicting survival 17 , 18 .…”

Section: Introductionmentioning

confidence: 99%

A Prognostic Nomogram for Cervical Cancer after Surgery from SEER Database

Wang¹,

Yang²,

Wang³

et al. 2018

J. Cancer

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Background: To develop and validate a nomogram based on the conventional measurements and log of odds between the number of positive lymph node and the number of negative lymph node (LODDS) in predicting prognosis for cervical cancer patients after surgery.Methods: A total of 8202 cervical cancer patients with pathologically confirmed between 2004 and 2014 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. All the patients were divided into training (n=3603) and validation (n=4599) cohorts based on consecutive age of diagnosis. Demographic and clinical pathological factors were evaluated the association with overall survival (OS). Parameters significantly correlating with OS were used to create a nomogram. An independent external validation cohort was subsequently used to assess the predictive performance of the model.Results: In the training set, age at diagnosis, race, marital status, tumor grade, FIGO stage, histology, size and LODDS were correlated significantly with outcome and used to develop a nomogram. The calibration curve for probability of survival showed excellent agreement between prediction by nomogram and actual observation in the training cohort, with a bootstrap-corrected concordance index of 0.749(95% CI, 0.731-0.767). Importantly, our nomogram performed favorably compared to the currently utilized FIGO model, with concordance indices of 0.786 (95% CI, 0.764 to 0.808) vs 0.685 (95%CI, 0.660 to 0.710) for OS in the validation cohort, respectively.Conclusions: By incorporating LODDS, our nomogram may be superior to the currently utilized FIGO staging system in predicting OS in cervical cancer patients after surgery.

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Section: Introductionmentioning

confidence: 99%

A Prognostic Nomogram for Cervical Cancer after Surgery from SEER Database

Wang¹,

Yang²,

Wang³

et al. 2018

J. Cancer

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“…18 One explanation for these different results may be that inadequate LN harvests could lead to stage migration and subsequent underestimation of disease severity, especially in those with pN1disease. 5 To our knowledge, our study is the rst to evaluate the bene t of postoperative radiotherapy by quality of neck dissection in patients with pN1 involvement and no risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…4 Cervical positive LNs, those most commonly related to recurrence, are recognized as among the most important prognostic factors in head and neck cancer. 5 Recent studies have con rmed that the number of evaluated LNs correlates with outcomes. 6,7 Ebrahimi et al reported that an LN yield < 18 was associated with worse 5-year overall (hazard ratio [HR], 2.0; 95% con dence interval [CI], 1.1-3.6), disease-speci c (HR, 2.2; 95% CI, 1.1-4.5), and disease-free survival (HR, 1.7; 95% CI, 1.1-2.8).…”

Section: Introductionmentioning

confidence: 99%

Postoperative Radiotherapy Improved Survival in pT1-2N1 Oral and Oropharyngeal Cancer Without Adequate Neck Dissection

Yang¹,

Kang²,

Liu³

et al. 2020

Preprint

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Background: To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection.Methods: In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were enrolled between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival(DSS).Results: Of the 1,765 patients identified, 1,108 (62.8%) had oral cancer, 1,141 (64.6%) were men, and 1,067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval[CI], 0.49-0.84) in those with <18 lymph nodes removed, but not in those with 19-24 lymph nodes removed (aHR, 0.78 ; 95% CI, 0.73-1.13), and in those with >25 lymph nodes removed (aHR, 0.96; 95% CI, 0.75-1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45-0.97) in those with <18 lymph nodes. The protective effect was not seen in those with 18-24 lymph nodes (aHR, 1.07; 95% CI 0.59-1.96), and in those with >25 lymph nodes (aHR, 1.12; 95% CI, 0.81-1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with <18 lymph nodes removed.Conclusion: Radiotherapy significantly improved survival in patients with pT1-2N1M0 oral and oropharyngeal cancer without adequate neck dissection.

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“…Cervical positive LNs, those most commonly related to recurrence, are recognized as among the most important prognostic factors in head and neck cancer [ 6 ]. Recent studies have confirmed that the number of evaluated LNs correlates with outcomes [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Postoperative radiotherapy is associated with improved survival in pT1-2N1 oral and oropharyngeal cancer without adequate neck dissection

et al. 2021

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Background To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection. Methods In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were included between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival (DSS) among different quality of neck dissection. Results Of the 1765 patients identified, 1108 (62.8%) had oral cancer, 1141 (64.6%) were men, and 1067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval [CI] 0.49–0.84) in those with < 18 lymph nodes (LNs) removed, but not in those with 19–24 LNs removed (aHR 0.78; 95% CI 0.73–1.13), and in those with ≥ 25 LNs removed (aHR 0.96; 95% CI 0.75–1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45–0.97) in those with < 18 LNs. The protective effect was not seen in those with 18–24 LNs (aHR 1.07; 95% CI 0.59–1.96), and in those with ≥ 25 LNs (aHR 1.12; 95% CI 0.81–1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with < 18 LNs removed. Conclusion Radiotherapy was associated with improved survival in pT1-2N1M0 oral and oropharyngeal cancer patients without adequate neck dissection.

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Recommendation for incorporation of a different lymph node scoring system in future AJCC N category for oral cancer

Cited by 27 publications

References 27 publications

A Prognostic Nomogram for Cervical Cancer after Surgery from SEER Database

A Prognostic Nomogram for Cervical Cancer after Surgery from SEER Database

Postoperative Radiotherapy Improved Survival in pT1-2N1 Oral and Oropharyngeal Cancer Without Adequate Neck Dissection

Postoperative radiotherapy is associated with improved survival in pT1-2N1 oral and oropharyngeal cancer without adequate neck dissection

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Recommendation for incorporation of a different lymph node scoring system in future AJCC N category for oral cancer

Cited by 27 publications

References 27 publications

A Prognostic Nomogram for Cervical Cancer after Surgery from SEER Database

A Prognostic Nomogram for Cervical Cancer after Surgery from SEER Database

Postoperative Radiotherapy Improved Survival in pT1-2N1 Oral and&nbsp;Oropharyngeal Cancer Without Adequate Neck Dissection ​

Postoperative radiotherapy is associated with improved survival in pT1-2N1 oral and oropharyngeal cancer without adequate neck dissection

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Postoperative Radiotherapy Improved Survival in pT1-2N1 Oral and Oropharyngeal Cancer Without Adequate Neck Dissection