Prognostic impact of lymph node count features in total laryngectomy for advanced laryngeal squamous cell carcinoma.

IF 2.8 3区医学 Q3 ONCOLOGY

Journal of Cancer Research and Clinical Oncology Pub Date : 2025-10-07 DOI:10.1007/s00432-025-06320-9

Mihnea Cristian Trache, Lisa Budelmann, Philippe Christophe Breda, Jördis Kristin Eden, Stefan Bartels, Sophia Marie Häußler, Christian Stephan Betz, Jacob Friedrich Clausen, Lukas Wittig, Arne Böttcher

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引用次数: 0

Abstract

Introduction: The optimal surgical management in advanced laryngeal squamous cell carcinoma (ALSCC) is still under debate. The extent of neck dissection as well as the nodal involvement affect survival metrics in head and neck cancer (HNSCC) patients. Despite pN status, other parameters like nodal yield (NY) or lymph node ratio (LNR) have been investigated before. There are data showing that log odds of positive lymph nodes (LODDS) are a good survival prognosticator in HNSCC in general but specific data on ALSCC is missing. This study aims to assess the prognostic value of lymph node count features on survival in ALSCC.

Methods: We conducted a retrospective patient chart review on curative intent laryngectomy and bilateral neck dissection for ALSCC between 2009 and 2024 at a tertiary care center. Investigated lymph node count features besides NY included lymph node burden (LNB = number of positive lymph nodes), LNR (= LNB/NY) and the LODDS = log ((LNB + 0.5) / (NY-LNB + 0.5)). Univariate survival analysis was performed using the log-rank testing and Kaplan-Meier curves. The R maxstat package was utilized for an optimized cut-off point determination for cohort risk stratification.

Results: We included 56 patients who underwent laryngectomy and bilateral neck dissection in our department. Survival analysis revealed a 5-year OS of 51% and median OS of 60.7 months. The LODDS ranged from -2.48 to 0.37 with a mean value of -1.68 ± 0.50. The cut-off at -1.94 for LODDS showed a 5-year DSF of 33% vs. 61% with a HR of 0.27 (p = 0.005) and the optimized cut-off of -1.55 showed significant differences in 5-year OS (69 vs. 17%, HR: 0.29, p = 0.003). LODDS indicated the highest concordance indices for both DFS and OS compared to LNB and LNR.

Conclusion: We propose LODDS to serve as a superior prognosticator compared to LNB and LNR concerning DFS and OS in TL for ALSCC. LODDS values of -1.94 for DFS and -1.55 for OS appear as suitable thresholds for risk stratification.

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晚期喉癌全喉切除术中淋巴结计数特征对预后的影响。

简介：晚期喉部鳞状细胞癌（ALSCC）的最佳手术治疗仍在争论中。颈部清扫的程度以及淋巴结的受累程度影响头颈癌（HNSCC）患者的生存指标。除了pN状态外，其他参数如淋巴结产率（NY）或淋巴结比（LNR）也曾被研究过。有数据显示，淋巴结阳性（LODDS）的对数赔率通常是HNSCC的良好预后指标，但关于ALSCC的具体数据缺失。本研究旨在评估淋巴结计数特征对ALSCC生存的预后价值。方法：我们对2009年至2024年在三级保健中心进行的治疗意图喉癌和双侧颈部清扫术的患者进行回顾性分析。除NY外，淋巴结计数特征还包括淋巴结负荷（LNB =阳性淋巴结数）、LNR （= LNB/NY）和LODDS = log (（LNB + 0.5) / (NY-LNB + 0.5)）。采用对数秩检验和Kaplan-Meier曲线进行单因素生存分析。rmaxstat包被用于确定队列风险分层的最佳截断点。结果：我们纳入56例在我科行喉切除术及双侧颈部清扫术的患者。生存分析显示5年OS为51%，中位OS为60.7个月。LODDS范围为-2.48 ~ 0.37，平均值为-1.68±0.50。LODDS的截止值为-1.94,5年DSF为33% vs. 61%， HR为0.27 (p = 0.005)；优化的截止值为-1.55,5年OS差异有统计学意义（69 vs. 17%, HR: 0.29, p = 0.003）。与LNB和LNR相比，LODDS显示DFS和OS的一致性指数最高。结论：与LNB和LNR相比，我们认为LODDS可以作为预测ALSCC TL患者DFS和OS的更优指标。DFS的LODDS值为-1.94，OS的LODDS值为-1.55，作为风险分层的合适阈值。

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

Journal of Cancer Research and Clinical Oncology 医学-肿瘤学

CiteScore

4.00

自引率

2.80%

发文量

577

审稿时长

2 months

期刊介绍： The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.