Association of Quantitative Metastatic Lymph Node Burden With Survival in Hypopharyngeal and Laryngeal Cancer

Abstract

The number of metastatic nodes is a predominant independent factor associated with mortality in hypopharyngeal and laryngeal cancers. Moreover, standard nodal staging factors like LN size and contralaterality have no independent prognostic value when accounting for positive LN number. Deeper integration of quantitative metastatic nodal disease may simplify staging and better triage the need for adjuvant therapy.

Development of a novel salivary gland cancer lymph node staging system

“…Other LN features including size, contralaterality, ENE, and lower neck involvement were found to have no impact on survival. The centrality of quantitative metastatic LN burden in determining survival in patients with SGC is consistent with its importance in other head and neck cancers, 8,11 and suggests that this variable should play a more prominent role in staging and, potentially, adjuvant treatment recommendations. Using RPA, we designed a novel SGC-specific LN staging system based on the number of positive LN.…”

“…Continued Number of positive metastatic LNs was modeled with 4 knots at the 63rd, 71st, 83rd, and 98th quantiles (1, 2, 6, and 37 LNs, respectively) and the number of LNs examined was modeled with 3 knots at the 10th, 50th, and 90th quantiles(11,26, and 52 LNs, respectively).…”

“…Summary of HRs for Number of Positive LNs and Number of LNs Examined Stratified by ChangepointMultivariable model was stratified based on grade and radiotherapy and adjusted for age, comorbidity, facility type, insurance, histology, T classification, surgical margins, chemotherapy, and regional LNs examined with 3 knots at the 10th, 50th, and 90th quantiles(11,26, and 52 LNs, respectively).…”

Significance of examined lymph nodes number and metastatic lymph nodes ratio in overall survival and adjuvant treatment decision in resected laryngeal carcinoma

“…Lymph node status is relatively important for laryngeal cancer, including the number of examined lymph nodes and the ratio of metastatic lymph nodes. Notably, the exact number of pathologically confirmed lymph nodes has been incorporated into the AJCC TNM stage system . However, accurate quantification of metastatic lymph nodes largely depends on a sufficient number of ELNs.…”

Morphological analysis of ischemia-reperfusion injury in a cold ischemia model of jejunal free flap for hypopharyngeal reconstruction

“…Although primary treatment of hypopharyngeal cancer is increasingly relying on nonsurgical modalities, for selected advanced stages and for patients in whom nonsurgical treatment fails, surgery remains the only curative option. 1,2 Surgical treatment of advanced hypopharyngeal cancer remains a challenge because of the difficulty of restoring digestive continuity, considering the distance covered, and the provision and maintenance of adequate blood supply to the reconstruction grafts, and ultimately, it depends on the amount of pharyngeal resection required. In some patients, the pharyngeal wound can be primarily closed, but extensive partial or circumferential pharyngeal resections require reconstruction to close the defect.…”