Lymph Node Ratio for Postoperative Staging of Laryngeal Squamous Cell Carcinoma with Lymph Node Metastasis

被引:2
作者
Wang, Yu-Long [1 ,2 ]
Li, Duan-Shu [1 ,2 ]
Wang, Yu [1 ,2 ]
Wang, Zhuo-Ying [1 ,2 ]
Ji, Qing-Hai [1 ,2 ]
机构
[1] Fudan Univ, Canc Hosp, Dept Head & Neck Surg, Shanghai 200433, Peoples R China
[2] Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai 200433, Peoples R China
基金
美国国家科学基金会;
关键词
POSITIVE BREAST-CANCER; LOCALLY ADVANCED HEAD; NECK CANCERS; SURGERY;
D O I
10.1371/journal.pone.0087037
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Lymph node metastasis has a significant impact on laryngeal cancer prognosis. The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of laryngeal cancer was not reported. Patients and Methods: Records of laryngeal cancer patients with lymph node involvement from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 1963) and Fudan University Shanghai Cancer Center (FDSCC, validating set, N = 27) were analyzed for the prognostic value of LNR. Kaplan-Meier survival estimates, the Log-rank x 2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile. Results: Optimal LNR cutoff points classified patients into three risk groups R1 (<= 0.09), R2 (0.09-0.20) and R3 (>0.20), corresponding to 5-year cause-specific survival and overall survival in SEER patients of 55.1%, 40.2%, 28.8% and 43.1%, 31.5%, 21.8%, 2-year disease free survival and disease specific survival in FDSCC patients of 74.1%, 62.5%, 50.0%, and 67.7%, 43.2%, 25.0%, respectively. R3 stratified more high risk patients than N3 with the same survival rate, and R classification clearly separated N2 patients to 3 risk groups and N1 patients to 2 risk groups (R1-2 and R3). Conclusions: R classification is a significant prognostic factor of laryngeal cancer and should be used as a complementary staging system of N classification.
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页数:7
相关论文
共 21 条
[1]   Defining risk levels in locally advanced head and neck cancers:: A comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (#9501) [J].
Bernier, J ;
Cooper, JS ;
Pajak, TF ;
van Glabbeke, M ;
Bourhis, J ;
Forastiere, A ;
Ozsahin, EM ;
Jacobs, JR ;
Jassem, J ;
Ang, KK ;
Lefèbvre, JL .
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2005, 27 (10) :843-850
[2]   Chemoradiation after surgery for high-risk head and neck cancer patients: How strong is the evidence? [J].
Bernier, J ;
Cooper, JS .
ONCOLOGIST, 2005, 10 (03) :215-224
[3]  
Buckley JG, 2000, HEAD NECK-J SCI SPEC, V22, P380, DOI 10.1002/1097-0347(200007)22:4<380::AID-HED11>3.0.CO
[4]  
2-E
[5]   X-tile: A new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization [J].
Camp, RL ;
Dolled-Filhart, M ;
Rimm, DL .
CLINICAL CANCER RESEARCH, 2004, 10 (21) :7252-7259
[6]  
CANDELA FC, 1990, ARCH OTOLARYNGOL, V116, P432
[7]   Prognostic Value of the Lymph Node Ratio in Stage III Colorectal Cancer: A Systematic Review [J].
Ceelen, W. ;
Van Nieuwenhove, Y. ;
Pattyn, P. .
ANNALS OF SURGICAL ONCOLOGY, 2010, 17 (11) :2847-2855
[8]  
Harrell FE, 1996, STAT MED, V15, P361, DOI 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO
[9]  
2-4
[10]  
Howlader N., 2011, SEER cancer statistics review, 1975-2008