The role of lymph node level ratio in predicting prognosis and the benefits of postoperative radiotherapy in patients with pathological N1 stage head and neck squamous cell carcinoma.

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-02-01 Epub Date: 2025-01-18 DOI:10.1016/j.oraloncology.2025.107193

Meng-Hua Li, Yu-Jun Hu, Hui-Min Shan, Xian-Lu Gao, Qi-Yu Huang, Wen-Yan Zhao, Shi-Ting Zhang, Ying Zhang, Shu-Wei Chen, Ming Song

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引用次数: 0

Abstract

Objective: To analyze the role of lymph node level ratio (LNLR) in predicting prognosis and the benefits of postoperative radiotherapy (PORT) in patients with pathological N1 (pN1) head and neck squamous cell carcinoma (HNSCC).

Methods: Patients with pN1 HNSCC from January 2011 to February 2021 were included. Patients were grouped by the LNLR, lymph node yield (LNY), and lymph node ratio (LNR) and were analyzed with the Kaplan-Meier method and multivariate Cox model.

Results: This study identified 310 patients. Time-dependent receiver operating characteristic analyses showed superior prognostic ability for LNLR in comparison with LNY and LNR. Patients with an LNLR ≤ 5.25 had the worst survival. Multivariate regressions demonstrated larger hazard ratios (HRs) and a higher concordance index for the LNLR model versus the LNY and LNR models. The HRs (95 % confidence interval) for a LNLR ≤ 5.25 were 2.46 (1.71-3.54, p < 0.001) for DFS, 1.95 (1.38-2.75, p < 0.001) for OS, 2.25 (1.53-3.29, p < 0.001) for DSS. Furthermore, postoperative radiotherapy-related significant improvement in survival was observed exclusively in the LNLR ≤ 5.25 subgroup.

Conclusion: The LNLR is a more robust quality indicator for neck dissection. An LNLR of ≤ 5.25 significantly compromises survival and indicates the need for PORT in patients with pN1 HNSCC.

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淋巴结水平比值对病理性N1期头颈部鳞状细胞癌患者预后及术后放疗效果的预测作用

目的：分析淋巴结水平比（LNLR）对病理性N1 （pN1）头颈部鳞状细胞癌（HNSCC）患者预后的预测作用及术后放疗（PORT）的益处。方法：纳入2011年1月至2021年2月的pN1型HNSCC患者。根据LNLR、淋巴结生成率（LNY）和淋巴结比率（LNR）分组，采用Kaplan-Meier法和多变量Cox模型进行分析。结果：本研究确定了310例患者。随时间变化的受者工作特征分析显示，与LNY和LNR相比，LNLR具有更好的预后能力。LNLR≤5.25的患者生存率最差。多变量回归显示LNLR模型与LNY和LNR模型相比具有更大的风险比（hr）和更高的一致性指数。LNLR≤5.25时的hr（95%可信区间）为2.46 （1.71 ~ 3.54,p）。结论：LNLR是颈淋巴清扫更可靠的质量指标。LNLR≤5.25显著影响pN1型HNSCC患者的生存，提示需要PORT。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.