Lymph node density as an independent predictor of cancer-specific mortality in patients with lymph node-positive laryngeal squamous cell carcinoma after laryngectomy

BackgroundWe examined the prognostic value of lymph node density in predicting cancer-specific mortality (CSM) for patients with lymph nodes positive (pN+) laryngeal squamous cell carcinoma (SCC) after laryngectomy. MethodsThe records of 156 patients with laryngeal SCC who initially underwent curative resection of the primary tumor combined with neck dissection were reviewed. ResultsThe 5-year cumulative incidence of CSM was 20.4%. N classification and extralaryngeal spread (ELS) were independent variables for CSM in all patients. Univariate analyses in 71 pN+ patients showed that ELS, number of positive lymph nodes >4, and lymph node density >0.044 were significantly associated with increased CSM, whereas pN classification was not (p=.218). On multivariate analysis, lymph node density 0.044 remained an independent predictor of CSM (p=.001). ConclusionAmong the pN+ patients with laryngeal SCC, no pN classification but lymph node density was noted to have an independent impact on CSM. (c) 2014 Wiley Periodicals, Inc. Head Neck 37: 1319-1325, 2015