TY - JOUR
T1 - Prognostic Value of Lymph Node Yield, Lymph Node Density, and pN in Oral Cancer
AU - Stampe, Helene
AU - Jakobsen, Kathrine Kronberg
AU - Tvedskov, Jesper Filtenborg
AU - Wessel, Irene
AU - Kiss, Katalin
AU - Friborg, Jeppe
AU - Andersen, Amanda Oester
AU - Grønhøj, Christian
AU - von Buchwald, Christian
AU - Christensen, Anders
PY - 2023/8
Y1 - 2023/8
N2 - OBJECTIVES: To investigate thresholds for lymph node yield (LNY), lymph node density (LND), and pN in patients with oral squamous cell carcinoma in relation to previous findings in the literature.STUDY DESIGN: Retrospective register-based study.SETTING: Copenhagen Oral Cavity Squamous Cell Carcinoma database.METHODS: Appropriate thresholds for LNY, LND, and pN were determined by areas under the curve and subsequently subjected to multivariate analysis. Five-year overall survival and 3-year recurrence-free survival were determined by Kaplan-Meier survival curves.RESULTS: In total, 413 patients diagnosed with oral squamous cell carcinoma were included. In the pN0 cohort, no superior/prognostic LNY cutoff values were detected. In the pN+ cohort, areas under the curve determined thresholds of LNY, LND, and pN to be 21 nodes, 5%, and 3 metastases, respectively. The 5-year overall survival was 52% for patients with LNY ≥21 vs 38% for patients with LNY <21 (hazard ratio [HR], 1.49; 95% CI, 1.05-2.11; P < .05), 60% for patients with LND ≤5% vs 38% for patients with LND >6% (HR, 1.63; 95% CI, 1.03-2.57; P < .05), and 43% for patients with pN <3 vs 26% for patients with pN ≥3 (HR, 1.40; 95% CI, 1.04-2.15; P < .05).CONCLUSIONS: Increased nodal yield, decreased LND, and decreasing number of pN were associated with significantly improved survival outcomes. LNY might serve as a prognosticator of survival as well as a surgical quality indicator. LND may have implications as a tool in cancer staging and treatment planning.
AB - OBJECTIVES: To investigate thresholds for lymph node yield (LNY), lymph node density (LND), and pN in patients with oral squamous cell carcinoma in relation to previous findings in the literature.STUDY DESIGN: Retrospective register-based study.SETTING: Copenhagen Oral Cavity Squamous Cell Carcinoma database.METHODS: Appropriate thresholds for LNY, LND, and pN were determined by areas under the curve and subsequently subjected to multivariate analysis. Five-year overall survival and 3-year recurrence-free survival were determined by Kaplan-Meier survival curves.RESULTS: In total, 413 patients diagnosed with oral squamous cell carcinoma were included. In the pN0 cohort, no superior/prognostic LNY cutoff values were detected. In the pN+ cohort, areas under the curve determined thresholds of LNY, LND, and pN to be 21 nodes, 5%, and 3 metastases, respectively. The 5-year overall survival was 52% for patients with LNY ≥21 vs 38% for patients with LNY <21 (hazard ratio [HR], 1.49; 95% CI, 1.05-2.11; P < .05), 60% for patients with LND ≤5% vs 38% for patients with LND >6% (HR, 1.63; 95% CI, 1.03-2.57; P < .05), and 43% for patients with pN <3 vs 26% for patients with pN ≥3 (HR, 1.40; 95% CI, 1.04-2.15; P < .05).CONCLUSIONS: Increased nodal yield, decreased LND, and decreasing number of pN were associated with significantly improved survival outcomes. LNY might serve as a prognosticator of survival as well as a surgical quality indicator. LND may have implications as a tool in cancer staging and treatment planning.
KW - lymph node density
KW - lymph node yield
KW - oral squamous cell carcinoma
KW - pN
KW - prognostic value
UR - http://www.scopus.com/inward/record.url?scp=85138415953&partnerID=8YFLogxK
U2 - 10.1177/01945998221123927
DO - 10.1177/01945998221123927
M3 - Journal article
C2 - 36066971
SN - 0194-5998
VL - 169
SP - 276
EP - 285
JO - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
IS - 2
ER -