Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study
Objectives Recently, multiple studies addressed the importance of lymph node ratio (LNR) in specifying patients’ risk of disease recurrence in various malignancies. The present study examines the prognostic significance of LNR in predicting outcome of oral squamous cell carcinoma (OSCC) patients aft...
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| Veröffentlicht in: | Clinical oral investigations 2021-04, Vol.25 (4), p.1705-1713 |
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| creator | Spoerl, Steffen Gerken, Michael Mamilos, Andreas Fischer, René Wolf, Stefanie Nieberle, Felix Klingelhöffer, Christoph Meier, Johannes K. Spoerl, Silvia Ettl, Tobias Reichert, Torsten E. Spanier, Gerrit |
| description | Objectives
Recently, multiple studies addressed the importance of lymph node ratio (LNR) in specifying patients’ risk of disease recurrence in various malignancies. The present study examines the prognostic significance of LNR in predicting outcome of oral squamous cell carcinoma (OSCC) patients after surgical treatment with curative intent.
Methods
Here, we describe a retrospective population-based cohort with 717 patients previously diagnosed with OSCC. Histopathologically verified lymph node metastasis was diagnosed in 290 patients. Among these patients, we evaluated the impact of LNR on overall survival (OAS) and recurrence-free survival (RFS) in uni- as well as multivariate analysis.
Results
A median cutoff (0.055) in LNR was found to significantly predict outcome in OSCC patients. Five-year OAS was 54.1% in patients with a low LNR, whereas a high LNR was associated with a 5-year OAS of 33.3% (
p |
| doi_str_mv | 10.1007/s00784-020-03471-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7966215</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2501660820</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-114b48228b8327514be585ac37b7895a0de2fc912e9d6c0bb749da64316f2ba33</originalsourceid><addsrcrecordid>eNp9Uctu1TAUtBCIlsIPsECW2LAx-BXbYYGEqhaQrsQG1pbjOL2uEjv1o-L-PU5vKY8FC790Zuac8QDwkuC3BGP5LrdNcYQpRphxSZB4BE4JZwIxKcnjuztFolfkBDzL-RpjwoVkT8EJo7LjUslT8GN3WNY9DHF0MJniIzQZGrgmN3pbYoJTW7EWGxcHfYAxmRnmm2qWWDO0bp6hNcn6EBfzvhGXOhdvXSguwTWudd40AxpMdiO0cR9TgbnU8fAcPJnMnN2L-_MMfL-8-Hb-Ge2-fvpy_nGHLJe8IEL4wBWlalDb0O3lOtUZy-QgVd8ZPDo62Z5Q14_C4mGQvB-N4IyIiQ6GsTPw4ai71mFx4zZas6DX5BeTDjoar_-uBL_XV_FWy14ISrom8OZeIMWb6nLRi8-bcRNc-wNNOcNC4r7fer3-B3odawrNnqYdJkJgRXFD0SPKpphzctPDMATrLVh9DFa3YPVdsFo00qs_bTxQfiXZAOwIyK0Urlz63fs_sj8BAo-wVw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2501660820</pqid></control><display><type>article</type><title>Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study</title><source>MEDLINE</source><source>SpringerLink_现刊</source><creator>Spoerl, Steffen ; Gerken, Michael ; Mamilos, Andreas ; Fischer, René ; Wolf, Stefanie ; Nieberle, Felix ; Klingelhöffer, Christoph ; Meier, Johannes K. ; Spoerl, Silvia ; Ettl, Tobias ; Reichert, Torsten E. ; Spanier, Gerrit</creator><creatorcontrib>Spoerl, Steffen ; Gerken, Michael ; Mamilos, Andreas ; Fischer, René ; Wolf, Stefanie ; Nieberle, Felix ; Klingelhöffer, Christoph ; Meier, Johannes K. ; Spoerl, Silvia ; Ettl, Tobias ; Reichert, Torsten E. ; Spanier, Gerrit</creatorcontrib><description>Objectives
Recently, multiple studies addressed the importance of lymph node ratio (LNR) in specifying patients’ risk of disease recurrence in various malignancies. The present study examines the prognostic significance of LNR in predicting outcome of oral squamous cell carcinoma (OSCC) patients after surgical treatment with curative intent.
Methods
Here, we describe a retrospective population-based cohort with 717 patients previously diagnosed with OSCC. Histopathologically verified lymph node metastasis was diagnosed in 290 patients. Among these patients, we evaluated the impact of LNR on overall survival (OAS) and recurrence-free survival (RFS) in uni- as well as multivariate analysis.
Results
A median cutoff (0.055) in LNR was found to significantly predict outcome in OSCC patients. Five-year OAS was 54.1% in patients with a low LNR, whereas a high LNR was associated with a 5-year OAS of 33.3% (
p
< 0.001). Similar results were detected for RFS with a 5-year survival rate of 49.8% (LNR low) and 30.3% (LNR high) (
p
= 0.002). Results were confirmed in multivariate Cox regression which substantiated the importance of LNR in predicting survival in OSCC patients.
Conclusions
LNR was shown to be an independent prognostic factor for outcome of OSCC in a population-based cohort in uni- as well as multivariate analysis. Hereby, a LNR ≥ 0.055 predicted a shorter OAS and RFS in our cohort.
Clinical relevance
Besides established histopathological factors, LNR can be used as a reliable predictor of outcome in OSCC and might therefore be further applied in evaluating adjuvant treatment after resection in curative intention.</description><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-020-03471-6</identifier><identifier>PMID: 32754787</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Cohort analysis ; Cohort Studies ; Dentistry ; Head and Neck Neoplasms ; Humans ; Lymph Node Excision ; Lymph Node Ratio ; Lymph Nodes ; Lymphatic system ; Medicine ; Metastases ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Multivariate analysis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Oral cancer ; Oral squamous cell carcinoma ; Original ; Original Article ; Patients ; Population studies ; Population-based studies ; Prognosis ; Retrospective Studies ; Risk assessment ; Squamous cell carcinoma ; Squamous Cell Carcinoma of Head and Neck</subject><ispartof>Clinical oral investigations, 2021-04, Vol.25 (4), p.1705-1713</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-114b48228b8327514be585ac37b7895a0de2fc912e9d6c0bb749da64316f2ba33</citedby><cites>FETCH-LOGICAL-c474t-114b48228b8327514be585ac37b7895a0de2fc912e9d6c0bb749da64316f2ba33</cites><orcidid>0000-0002-0226-7580</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00784-020-03471-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-020-03471-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32754787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spoerl, Steffen</creatorcontrib><creatorcontrib>Gerken, Michael</creatorcontrib><creatorcontrib>Mamilos, Andreas</creatorcontrib><creatorcontrib>Fischer, René</creatorcontrib><creatorcontrib>Wolf, Stefanie</creatorcontrib><creatorcontrib>Nieberle, Felix</creatorcontrib><creatorcontrib>Klingelhöffer, Christoph</creatorcontrib><creatorcontrib>Meier, Johannes K.</creatorcontrib><creatorcontrib>Spoerl, Silvia</creatorcontrib><creatorcontrib>Ettl, Tobias</creatorcontrib><creatorcontrib>Reichert, Torsten E.</creatorcontrib><creatorcontrib>Spanier, Gerrit</creatorcontrib><title>Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objectives
Recently, multiple studies addressed the importance of lymph node ratio (LNR) in specifying patients’ risk of disease recurrence in various malignancies. The present study examines the prognostic significance of LNR in predicting outcome of oral squamous cell carcinoma (OSCC) patients after surgical treatment with curative intent.
Methods
Here, we describe a retrospective population-based cohort with 717 patients previously diagnosed with OSCC. Histopathologically verified lymph node metastasis was diagnosed in 290 patients. Among these patients, we evaluated the impact of LNR on overall survival (OAS) and recurrence-free survival (RFS) in uni- as well as multivariate analysis.
Results
A median cutoff (0.055) in LNR was found to significantly predict outcome in OSCC patients. Five-year OAS was 54.1% in patients with a low LNR, whereas a high LNR was associated with a 5-year OAS of 33.3% (
p
< 0.001). Similar results were detected for RFS with a 5-year survival rate of 49.8% (LNR low) and 30.3% (LNR high) (
p
= 0.002). Results were confirmed in multivariate Cox regression which substantiated the importance of LNR in predicting survival in OSCC patients.
Conclusions
LNR was shown to be an independent prognostic factor for outcome of OSCC in a population-based cohort in uni- as well as multivariate analysis. Hereby, a LNR ≥ 0.055 predicted a shorter OAS and RFS in our cohort.
Clinical relevance
Besides established histopathological factors, LNR can be used as a reliable predictor of outcome in OSCC and might therefore be further applied in evaluating adjuvant treatment after resection in curative intention.</description><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Dentistry</subject><subject>Head and Neck Neoplasms</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymph Node Ratio</subject><subject>Lymph Nodes</subject><subject>Lymphatic system</subject><subject>Medicine</subject><subject>Metastases</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Multivariate analysis</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging</subject><subject>Oral cancer</subject><subject>Oral squamous cell carcinoma</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk assessment</subject><subject>Squamous cell carcinoma</subject><subject>Squamous Cell Carcinoma of Head and Neck</subject><issn>1432-6981</issn><issn>1436-3771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9Uctu1TAUtBCIlsIPsECW2LAx-BXbYYGEqhaQrsQG1pbjOL2uEjv1o-L-PU5vKY8FC790Zuac8QDwkuC3BGP5LrdNcYQpRphxSZB4BE4JZwIxKcnjuztFolfkBDzL-RpjwoVkT8EJo7LjUslT8GN3WNY9DHF0MJniIzQZGrgmN3pbYoJTW7EWGxcHfYAxmRnmm2qWWDO0bp6hNcn6EBfzvhGXOhdvXSguwTWudd40AxpMdiO0cR9TgbnU8fAcPJnMnN2L-_MMfL-8-Hb-Ge2-fvpy_nGHLJe8IEL4wBWlalDb0O3lOtUZy-QgVd8ZPDo62Z5Q14_C4mGQvB-N4IyIiQ6GsTPw4ai71mFx4zZas6DX5BeTDjoar_-uBL_XV_FWy14ISrom8OZeIMWb6nLRi8-bcRNc-wNNOcNC4r7fer3-B3odawrNnqYdJkJgRXFD0SPKpphzctPDMATrLVh9DFa3YPVdsFo00qs_bTxQfiXZAOwIyK0Urlz63fs_sj8BAo-wVw</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Spoerl, Steffen</creator><creator>Gerken, Michael</creator><creator>Mamilos, Andreas</creator><creator>Fischer, René</creator><creator>Wolf, Stefanie</creator><creator>Nieberle, Felix</creator><creator>Klingelhöffer, Christoph</creator><creator>Meier, Johannes K.</creator><creator>Spoerl, Silvia</creator><creator>Ettl, Tobias</creator><creator>Reichert, Torsten E.</creator><creator>Spanier, Gerrit</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0226-7580</orcidid></search><sort><creationdate>20210401</creationdate><title>Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study</title><author>Spoerl, Steffen ; Gerken, Michael ; Mamilos, Andreas ; Fischer, René ; Wolf, Stefanie ; Nieberle, Felix ; Klingelhöffer, Christoph ; Meier, Johannes K. ; Spoerl, Silvia ; Ettl, Tobias ; Reichert, Torsten E. ; Spanier, Gerrit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-114b48228b8327514be585ac37b7895a0de2fc912e9d6c0bb749da64316f2ba33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Dentistry</topic><topic>Head and Neck Neoplasms</topic><topic>Humans</topic><topic>Lymph Node Excision</topic><topic>Lymph Node Ratio</topic><topic>Lymph Nodes</topic><topic>Lymphatic system</topic><topic>Medicine</topic><topic>Metastases</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Multivariate analysis</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging</topic><topic>Oral cancer</topic><topic>Oral squamous cell carcinoma</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk assessment</topic><topic>Squamous cell carcinoma</topic><topic>Squamous Cell Carcinoma of Head and Neck</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spoerl, Steffen</creatorcontrib><creatorcontrib>Gerken, Michael</creatorcontrib><creatorcontrib>Mamilos, Andreas</creatorcontrib><creatorcontrib>Fischer, René</creatorcontrib><creatorcontrib>Wolf, Stefanie</creatorcontrib><creatorcontrib>Nieberle, Felix</creatorcontrib><creatorcontrib>Klingelhöffer, Christoph</creatorcontrib><creatorcontrib>Meier, Johannes K.</creatorcontrib><creatorcontrib>Spoerl, Silvia</creatorcontrib><creatorcontrib>Ettl, Tobias</creatorcontrib><creatorcontrib>Reichert, Torsten E.</creatorcontrib><creatorcontrib>Spanier, Gerrit</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Biological Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical oral investigations</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spoerl, Steffen</au><au>Gerken, Michael</au><au>Mamilos, Andreas</au><au>Fischer, René</au><au>Wolf, Stefanie</au><au>Nieberle, Felix</au><au>Klingelhöffer, Christoph</au><au>Meier, Johannes K.</au><au>Spoerl, Silvia</au><au>Ettl, Tobias</au><au>Reichert, Torsten E.</au><au>Spanier, Gerrit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>25</volume><issue>4</issue><spage>1705</spage><epage>1713</epage><pages>1705-1713</pages><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objectives
Recently, multiple studies addressed the importance of lymph node ratio (LNR) in specifying patients’ risk of disease recurrence in various malignancies. The present study examines the prognostic significance of LNR in predicting outcome of oral squamous cell carcinoma (OSCC) patients after surgical treatment with curative intent.
Methods
Here, we describe a retrospective population-based cohort with 717 patients previously diagnosed with OSCC. Histopathologically verified lymph node metastasis was diagnosed in 290 patients. Among these patients, we evaluated the impact of LNR on overall survival (OAS) and recurrence-free survival (RFS) in uni- as well as multivariate analysis.
Results
A median cutoff (0.055) in LNR was found to significantly predict outcome in OSCC patients. Five-year OAS was 54.1% in patients with a low LNR, whereas a high LNR was associated with a 5-year OAS of 33.3% (
p
< 0.001). Similar results were detected for RFS with a 5-year survival rate of 49.8% (LNR low) and 30.3% (LNR high) (
p
= 0.002). Results were confirmed in multivariate Cox regression which substantiated the importance of LNR in predicting survival in OSCC patients.
Conclusions
LNR was shown to be an independent prognostic factor for outcome of OSCC in a population-based cohort in uni- as well as multivariate analysis. Hereby, a LNR ≥ 0.055 predicted a shorter OAS and RFS in our cohort.
Clinical relevance
Besides established histopathological factors, LNR can be used as a reliable predictor of outcome in OSCC and might therefore be further applied in evaluating adjuvant treatment after resection in curative intention.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32754787</pmid><doi>10.1007/s00784-020-03471-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0226-7580</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical oral investigations, 2021-04, Vol.25 (4), p.1705-1713 |
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| language | eng |
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| source | MEDLINE; SpringerLink_现刊 |
| subjects | Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Cohort analysis Cohort Studies Dentistry Head and Neck Neoplasms Humans Lymph Node Excision Lymph Node Ratio Lymph Nodes Lymphatic system Medicine Metastases Mouth Neoplasms - pathology Mouth Neoplasms - surgery Multivariate analysis Neoplasm Recurrence, Local Neoplasm Staging Oral cancer Oral squamous cell carcinoma Original Original Article Patients Population studies Population-based studies Prognosis Retrospective Studies Risk assessment Squamous cell carcinoma Squamous Cell Carcinoma of Head and Neck |
| title | Lymph node ratio as a predictor for outcome in oral squamous cell carcinoma: a multicenter population-based cohort study |
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