Prognostic Implications of the Number of Lymph Node Metastases in Oral Tongue Squamous Cell Carcinoma: A Population Study of the SEER Database and an Institutional Registry

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-12-19 DOI:10.1002/cam4.70493

Wenjie Huang, Yu Zhang, Hao Li, Zhiying Liang, Shumin Zhou, Jie Pan, Hui Xie, Chao Luo, Shuqi Li, Guangying Ruan, Fei Ai, Yanfeng Chen

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引用次数: 0

Abstract

Background

To investigate the impact of the number of positive lymph nodes (PLNs) on long-term survival and pathological nodal stage in patients with oral tongue squamous cell carcinoma (OTSCC).

Materials and Methods

Newly diagnosed and nonmetastatic adult patients with OTSCC who underwent curative resection were identified between January 2010 and December 2020. External validation was performed via the SEER registry. Multivariate Cox proportional hazards model was employed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of pathological nodal features. Propensity score matching (PSM) was used to assess effect of adjuvant chemoradiotherapy (ACRT).

Results

Among 518 curative-intent OTSCC patients, the number of PLNs independently predicted overall survival (OS), surpassing other pathological nodal features, including extranodal extension, laterality, and lower neck involvement. Patients with 1 or 2 PLNs had comparable worse OS than those with no PLN (median OS of 1 PLN vs. 2 PLNs vs. 0 PLN: 35.1 vs. 30.5 vs. 40.2 months), but better than those with ≥ 3 PLNs (median OS of 1–2 PLNs vs. 3 PLNs: 32.1 vs. 19.0 months). A proposed nodal category with 0, 1–2 PLNs, and ≥ 3 PLNs exhibited increasingly worse OS (HR of 1–2 PLNs and ≥ 3 PLNs vs. 0 PLN: 2.98 [95% CI: 1.89–4.71], p < 0.001; 5.47 [95% CI: 3.33–9], p < 0.001; respectively) and showed improved prediction power versus current pN staging (C-index: 0.717 vs. 0.713, p < 0.001). PSM analysis revealed that ACRT benefited patients with advanced nodal disease (≥ 3 PLNs) and improved OS. These findings were validated in SEER registry.

Conclusion

The number of PLNs is a better predictor of overall tumor burden for OTSCC and could be a more accurate metric for survival estimation, which should be considered in future simplified pathological nodal staging for better risk stratification and decision-making in subsites of the oral cavity.

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.