Prognostic value of lymph node involvement in oral squamous cell carcinoma
Objectives Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and extracapsular spread. Moreover, other factors, including the lymph node ratio (LNR) and lymph node yield (LNY), have been s...
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| Veröffentlicht in: | Clinical oral investigations 2022-11, Vol.26 (11), p.6711-6720 |
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| container_title | Clinical oral investigations |
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| creator | Voss, Jan Oliver Freund, Lea Neumann, Felix Mrosk, Friedrich Rubarth, Kerstin Kreutzer, Kilian Doll, Christian Heiland, Max Koerdt, Steffen |
| description | Objectives
Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and extracapsular spread. Moreover, other factors, including the lymph node ratio (LNR) and lymph node yield (LNY), have been suggested as prognostic markers.
Material and methods
This retrospective study included patients diagnosed with OSCC and cervical lymph node metastases during the years 2010–2020. Patients’ records were evaluated regarding lymph node status, final therapy regime, tumour recurrence, time to death, tumour association with death, disease-free survival (DSF), and overall survival (OS).
Results
In 242 patients with a mean age of 63.57 ± 11.24 years, treated either by selective neck dissection (SND;
n
= 70) or by modified radical neck dissection (MRND;
n
= 172), 5772 lymph nodes were detected. The LNR and LNY were identified as independent risk factors in OS and DFS. The optimal cut-off point for the LNY was ≥ 17 lymph nodes in the SND and ≥ 27 lymph nodes in the MRND group.
The metastatic lymph node clearance (MLNC) was established as a score to relate the LNR and LNY to the extent of lymph node removal. Survival analysis showed statistically significant differences among score levels.
Conclusions
As information about the extent of nodal dissection is excluded from LNR and LNY, we propose the use of a new scoring system comprising individual cut-off values for LNY and LNR with regard to the extent of neck dissection.
Clinical Relevance
MLNC might help to identify high-risk OSCC patients with metastatic lymph nodes. |
| doi_str_mv | 10.1007/s00784-022-04630-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9643253</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2733854490</sourcerecordid><originalsourceid>FETCH-LOGICAL-c404t-95750b36437407a327c1f5cadc997528b279c2297317da514c9b8d6e7fc220a33</originalsourceid><addsrcrecordid>eNp9UctOwzAQtBCIlsIPcECWuHAJOH7E8QUJVTxVCQ5wtlzHaVMldms3kfr3uLSUwoGLvdqdnZ3RAHCeousUIX4T4pPTBGGcIJoRlPAD0E8pyRLCeXq4V_fASQgzhFKacXIMeoTlgsVpH7y8eTexLiwrDTtVtwa6EtarZj6F1hUGVrZzdWcaY5exhs6rGoZFqxrXBqhNXUOtvK6sa9QpOCpVHczZ9h-Aj4f79-FTMnp9fB7ejRJNEV0mgnGGxiSjhFPEFcFcpyXTqtBCcIbzMeZCYyw4SXmhokotxnmRGV7GLlKEDMDthnfejhtT6CgtqpJzXzXKr6RTlfw9sdVUTlwnRbyJ2Zrgakvg3aI1YSmbKqy9KGuiLYkzwbDAKM8j9PIPdOZab6M9iTkhOaNUoIjCG5T2LgRvyp2YFMl1VHITlYxRya-oJI9LF_s2divf2UQA2QBCHNmJ8T-3_6H9BHbJntI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2733854490</pqid></control><display><type>article</type><title>Prognostic value of lymph node involvement in oral squamous cell carcinoma</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Voss, Jan Oliver ; Freund, Lea ; Neumann, Felix ; Mrosk, Friedrich ; Rubarth, Kerstin ; Kreutzer, Kilian ; Doll, Christian ; Heiland, Max ; Koerdt, Steffen</creator><creatorcontrib>Voss, Jan Oliver ; Freund, Lea ; Neumann, Felix ; Mrosk, Friedrich ; Rubarth, Kerstin ; Kreutzer, Kilian ; Doll, Christian ; Heiland, Max ; Koerdt, Steffen</creatorcontrib><description>Objectives
Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and extracapsular spread. Moreover, other factors, including the lymph node ratio (LNR) and lymph node yield (LNY), have been suggested as prognostic markers.
Material and methods
This retrospective study included patients diagnosed with OSCC and cervical lymph node metastases during the years 2010–2020. Patients’ records were evaluated regarding lymph node status, final therapy regime, tumour recurrence, time to death, tumour association with death, disease-free survival (DSF), and overall survival (OS).
Results
In 242 patients with a mean age of 63.57 ± 11.24 years, treated either by selective neck dissection (SND;
n
= 70) or by modified radical neck dissection (MRND;
n
= 172), 5772 lymph nodes were detected. The LNR and LNY were identified as independent risk factors in OS and DFS. The optimal cut-off point for the LNY was ≥ 17 lymph nodes in the SND and ≥ 27 lymph nodes in the MRND group.
The metastatic lymph node clearance (MLNC) was established as a score to relate the LNR and LNY to the extent of lymph node removal. Survival analysis showed statistically significant differences among score levels.
Conclusions
As information about the extent of nodal dissection is excluded from LNR and LNY, we propose the use of a new scoring system comprising individual cut-off values for LNY and LNR with regard to the extent of neck dissection.
Clinical Relevance
MLNC might help to identify high-risk OSCC patients with metastatic lymph nodes.</description><identifier>ISSN: 1436-3771</identifier><identifier>ISSN: 1432-6981</identifier><identifier>EISSN: 1436-3771</identifier><identifier>DOI: 10.1007/s00784-022-04630-7</identifier><identifier>PMID: 35895143</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Carcinoma, Squamous Cell - pathology ; Dentistry ; Dissection ; Head and Neck Neoplasms - pathology ; Humans ; Lymph nodes ; Lymph Nodes - pathology ; Lymphatic system ; Medicine ; Metastases ; Metastasis ; Middle Aged ; Mouth Neoplasms - pathology ; Mouth Neoplasms - surgery ; Neck ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Oral cancer ; Oral carcinoma ; Oral squamous cell carcinoma ; Original ; Original Article ; Patients ; Prognosis ; Retrospective Studies ; Risk factors ; Squamous cell carcinoma ; Squamous Cell Carcinoma of Head and Neck - pathology ; Statistical analysis ; Survival analysis ; Tumors</subject><ispartof>Clinical oral investigations, 2022-11, Vol.26 (11), p.6711-6720</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. 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-c404t-95750b36437407a327c1f5cadc997528b279c2297317da514c9b8d6e7fc220a33</citedby><cites>FETCH-LOGICAL-c404t-95750b36437407a327c1f5cadc997528b279c2297317da514c9b8d6e7fc220a33</cites><orcidid>0000-0002-1760-2599</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/s00784-022-04630-7$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00784-022-04630-7$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35895143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Voss, Jan Oliver</creatorcontrib><creatorcontrib>Freund, Lea</creatorcontrib><creatorcontrib>Neumann, Felix</creatorcontrib><creatorcontrib>Mrosk, Friedrich</creatorcontrib><creatorcontrib>Rubarth, Kerstin</creatorcontrib><creatorcontrib>Kreutzer, Kilian</creatorcontrib><creatorcontrib>Doll, Christian</creatorcontrib><creatorcontrib>Heiland, Max</creatorcontrib><creatorcontrib>Koerdt, Steffen</creatorcontrib><title>Prognostic value of lymph node involvement in oral squamous cell carcinoma</title><title>Clinical oral investigations</title><addtitle>Clin Oral Invest</addtitle><addtitle>Clin Oral Investig</addtitle><description>Objectives
Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and extracapsular spread. Moreover, other factors, including the lymph node ratio (LNR) and lymph node yield (LNY), have been suggested as prognostic markers.
Material and methods
This retrospective study included patients diagnosed with OSCC and cervical lymph node metastases during the years 2010–2020. Patients’ records were evaluated regarding lymph node status, final therapy regime, tumour recurrence, time to death, tumour association with death, disease-free survival (DSF), and overall survival (OS).
Results
In 242 patients with a mean age of 63.57 ± 11.24 years, treated either by selective neck dissection (SND;
n
= 70) or by modified radical neck dissection (MRND;
n
= 172), 5772 lymph nodes were detected. The LNR and LNY were identified as independent risk factors in OS and DFS. The optimal cut-off point for the LNY was ≥ 17 lymph nodes in the SND and ≥ 27 lymph nodes in the MRND group.
The metastatic lymph node clearance (MLNC) was established as a score to relate the LNR and LNY to the extent of lymph node removal. Survival analysis showed statistically significant differences among score levels.
Conclusions
As information about the extent of nodal dissection is excluded from LNR and LNY, we propose the use of a new scoring system comprising individual cut-off values for LNY and LNR with regard to the extent of neck dissection.
Clinical Relevance
MLNC might help to identify high-risk OSCC patients with metastatic lymph nodes.</description><subject>Aged</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Dentistry</subject><subject>Dissection</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Humans</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic system</subject><subject>Medicine</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mouth Neoplasms - pathology</subject><subject>Mouth Neoplasms - surgery</subject><subject>Neck</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Oral cancer</subject><subject>Oral carcinoma</subject><subject>Oral squamous cell carcinoma</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Squamous cell carcinoma</subject><subject>Squamous Cell Carcinoma of Head and Neck - 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pathology</topic><topic>Dentistry</topic><topic>Dissection</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Humans</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic system</topic><topic>Medicine</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mouth Neoplasms - pathology</topic><topic>Mouth Neoplasms - surgery</topic><topic>Neck</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Oral cancer</topic><topic>Oral carcinoma</topic><topic>Oral squamous cell carcinoma</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Squamous cell carcinoma</topic><topic>Squamous Cell Carcinoma of Head and Neck - pathology</topic><topic>Statistical analysis</topic><topic>Survival analysis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Voss, Jan Oliver</creatorcontrib><creatorcontrib>Freund, Lea</creatorcontrib><creatorcontrib>Neumann, Felix</creatorcontrib><creatorcontrib>Mrosk, Friedrich</creatorcontrib><creatorcontrib>Rubarth, Kerstin</creatorcontrib><creatorcontrib>Kreutzer, Kilian</creatorcontrib><creatorcontrib>Doll, Christian</creatorcontrib><creatorcontrib>Heiland, Max</creatorcontrib><creatorcontrib>Koerdt, Steffen</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>Health & Medical Collection</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 Edition)</collection><collection>ProQuest Central UK/Ireland</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>Medical Database</collection><collection>Biological Science Database</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>Voss, Jan Oliver</au><au>Freund, Lea</au><au>Neumann, Felix</au><au>Mrosk, Friedrich</au><au>Rubarth, Kerstin</au><au>Kreutzer, Kilian</au><au>Doll, Christian</au><au>Heiland, Max</au><au>Koerdt, Steffen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of lymph node involvement in oral squamous cell carcinoma</atitle><jtitle>Clinical oral investigations</jtitle><stitle>Clin Oral Invest</stitle><addtitle>Clin Oral Investig</addtitle><date>2022-11-01</date><risdate>2022</risdate><volume>26</volume><issue>11</issue><spage>6711</spage><epage>6720</epage><pages>6711-6720</pages><issn>1436-3771</issn><issn>1432-6981</issn><eissn>1436-3771</eissn><abstract>Objectives
Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and extracapsular spread. Moreover, other factors, including the lymph node ratio (LNR) and lymph node yield (LNY), have been suggested as prognostic markers.
Material and methods
This retrospective study included patients diagnosed with OSCC and cervical lymph node metastases during the years 2010–2020. Patients’ records were evaluated regarding lymph node status, final therapy regime, tumour recurrence, time to death, tumour association with death, disease-free survival (DSF), and overall survival (OS).
Results
In 242 patients with a mean age of 63.57 ± 11.24 years, treated either by selective neck dissection (SND;
n
= 70) or by modified radical neck dissection (MRND;
n
= 172), 5772 lymph nodes were detected. The LNR and LNY were identified as independent risk factors in OS and DFS. The optimal cut-off point for the LNY was ≥ 17 lymph nodes in the SND and ≥ 27 lymph nodes in the MRND group.
The metastatic lymph node clearance (MLNC) was established as a score to relate the LNR and LNY to the extent of lymph node removal. Survival analysis showed statistically significant differences among score levels.
Conclusions
As information about the extent of nodal dissection is excluded from LNR and LNY, we propose the use of a new scoring system comprising individual cut-off values for LNY and LNR with regard to the extent of neck dissection.
Clinical Relevance
MLNC might help to identify high-risk OSCC patients with metastatic lymph nodes.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35895143</pmid><doi>10.1007/s00784-022-04630-7</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1760-2599</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical oral investigations, 2022-11, Vol.26 (11), p.6711-6720 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Carcinoma, Squamous Cell - pathology Dentistry Dissection Head and Neck Neoplasms - pathology Humans Lymph nodes Lymph Nodes - pathology Lymphatic system Medicine Metastases Metastasis Middle Aged Mouth Neoplasms - pathology Mouth Neoplasms - surgery Neck Neoplasm Recurrence, Local - pathology Neoplasm Staging Oral cancer Oral carcinoma Oral squamous cell carcinoma Original Original Article Patients Prognosis Retrospective Studies Risk factors Squamous cell carcinoma Squamous Cell Carcinoma of Head and Neck - pathology Statistical analysis Survival analysis Tumors |
| title | Prognostic value of lymph node involvement in oral squamous cell carcinoma |
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