Details

Autor(en) / Beteiligte

• Kang, Chung-Jan
• Wen, Yu-Wen
• Lee, Shu-Ru
• Ng, Shu-Hang
• Tsai, Chi-Ying
• Lee, Li-Yu
• Chu, Ying-Hsia
• Lin, Chien-Yu
• Fan, Kang-Hsing
• Wang, Hung-Ming
• Hsieh, Chia-Hsun
• Yeh, Chih-Hua
• Lin, Chih-Hung
• Tsao, Chung-Kan
• Fang, Tuan-Jen
• Huang, Shiang-Fu
• Lee, Li-Ang
• Fang, Ku-Hao
• Wang, Yu-Chien
• Lin, Wan-Ni
• Hsin, Li-Jen
• Yen, Tzu-Chen
• Cheng, Nai-Ming
• Liao, Chun-Ta

Titel

Towards an Improved Pathological Node Classification for Prognostic Stratification of Patients With Oral Cavity Squamous Cell Carcinoma: Results From a Nationwide Registry Study

Ist Teil von

• Frontiers in oncology, 2022-06, Vol.12, p.910158-910158

Ort / Verlag

Frontiers Media S.A

Erscheinungsjahr

2022

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background To assess the prognostic significance of different nodal parameters [i.e., number of pathologically positive nodes, log odds of positive lymph nodes, lymph node ratio (LNR), and extra-nodal extension (ENE)] in Taiwanese patients with oral cavity squamous cell carcinoma (OCSCC), and to devise an optimized pN classification system for predicting survival in OCSCC. Methods A total of 4287 Taiwanese patients with first primary OCSCC and nodal metastases were enrolled. Cox proportional hazards regression analysis with the spline method was applied to identify the optimal cut-off values for LNR, log odds of positive lymph nodes, and number of pathologically positive nodes. Results On multivariable analysis, we identified a LNR ≥0.078/0.079, the presence of at least three pathologically positive nodes, and ENE as independent prognosticators for 5-year disease-specific survival (DSS) and overall survival (OS) rates. We therefore devised a four-point prognostic scoring system according to the presence or absence of each variable. The 5-year DSS and OS rates of patients with scores of 0−3 were 70%/62%/50%/36% ( p < 0.0001) and 61%/52%/40%25%, respectively ( p < 0.0001). On analyzing the AJCC 2017 pN classification, patients with pN3a displayed better survival rates than those with pN2 disease. The 5-year DSS and OS rates of patients with pN1/pN2/pN3a/pN3b disease were 72%/60%/67%/43% ( p < 0.0001) and 63%/51%/67%/33%, respectively ( p < 0.0001). Conclusions Three nodal parameters (i.e., a LNR ≥0.078/0.079, the presence of at least three pathologically positive nodes, and ENE) assessed in combination provided a better prognostic stratification than the traditional AJCC pN classification.