Journal ArticleDOI
Can metastatic lymph node ratio (LNR) predict survival in oral cavity cancer patients
Suhail I. Sayed,Shilpi Sharma,P. Rane,Sagar Vaishampayan,Sanjay Talole,Pankaj Chaturvedi,Devendra Chaukar,Anuja Deshmukh,Jai Prakash Agarwal,Anil K. D'Cruz +9 more
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TLDR
To evaluate the prognostic role of the lymph node ratio (LNR; ratio of total positive nodes to total dissected nodes) in oral squamous cell carcinoma (OSCC) as compared to pN staging with an aim to provide an optimal cut‐off value.Abstract:
Objectives
To evaluate the prognostic role of the lymph node ratio (LNR; ratio of total positive nodes to total dissected nodes) in oral squamous cell carcinoma (OSCC) as compared to pN staging with an aim to provide an optimal cut-off value.
Methods
1,408 OSCC previously untreated patients who underwent treatment (surgery + neck dissection + adjuvant treatment). LNR sensitivity with respect to survival was calculated using receiver operating characteristic (ROC) curves and Cox regression method. LNR and TNM staging variables were subjected to multivariate analysis.
Results
LNR (0.088) showed significant association with survival outcomes. For patients with LNR ≤0.088, the OS, DFS, local control, regional control and distant metastasis rates were 64%, 70%, and 89%; for LNR >0.088 it was 22%, 19%, and 52%, respectively (P < 0.001). On multivariate analysis LNR of 0.088 was seen to be an independent prognostic factor for 5-year regional control (p, hazard ratio [95% confidence interval]; 0.044, 2.016 (1.019–3.990), DFS, 0.032, 1.858 (1.054–3.276), and OS, 0.040, 1.195 (1.033–1.144). On multivariate analysis LNR categorization showed a statistically significant [0.032, 1.858, (1.054–3.276)] advantage over pN staging [0.527, 1.208 (1.054–3.276)] in predicting survival.
Conclusions
LNR is a better prognostic marker than the current N staging of TNM classification. J. Surg. Oncol. 2013 108:256–263. © 2013 Wiley Periodicals, Inc.read more
Citations
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Journal ArticleDOI
Lymph node density in oral cavity cancer: Results of the International Consortium for Outcomes Research
Snehal G. Patel,Moran Amit,Tzu Chen Yen,Chun-Ta Liao,Pankaj Chaturvedi,Jai Prakash Agarwal,Luiz Paulo Kowalski,Ardalan Ebrahimi,Jonathan R. Clark,Claudio Roberto Cernea,S. J. Brandao,Matthias Kreppel,Joachim E. Zöller,Dan M. Fliss,Eran Fridman,Gideon Bachar,Thomas Shpitzer,V. A. Bolzoni,P.R. Patel,S. Jonnalagadda,K. T. Robbins,Jatin P. Shah,Ziv Gil +22 more
TL;DR: This multi-institutional study validates the reliability and applicability of LND as a predictor of outcomes in oral cavity squamous cell carcinoma and can potentially assist in identifying patients with poor outcomes and therefore for whom more aggressive adjuvant treatment is needed.
Journal ArticleDOI
Lymph node ratio as a prognostic factor in head and neck cancer patients
TL;DR: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in head and neck cancer patients who received surgery plus postoperative chemoradiotherapy and revealed that LNR was an independent prognostic factor for OS and LFFS.
Journal ArticleDOI
Lymph node ratio as prognostic variable in oral squamous cell carcinomas: Systematic review and meta-analysis.
TL;DR: LNR is an independent prognostic factor in OSCC and may be considered in future oncologic staging systems and there was no strong evidence to consider a possibility of a second significant value.
Journal ArticleDOI
Prognostic value of lymph node ratio in head and neck squamous cell carcinoma
Yoav P. Talmi,Robert P. Takes,Eran E. Alon,Iain J. Nixon,Fernando López,Remco de Bree,Juan P. Rodrigo,Ashok R. Shaha,Gyorgy B. Halmos,Alessandra Rinaldo,Alfio Ferlito +10 more
TL;DR: The purpose of this review was to analyze the available literature on the prognostic significance of LNR in head and neck squamous cell carcinoma (HNSCC).
Journal ArticleDOI
Squamous cell carcinoma of buccal mucosa: An analysis of prognostic factors.
TL;DR: In addition to TNM classification, other clinical and pathological factors also have a significant role in BMSCC prognostication and there is a need to move beyond TNM and develop a more inclusive, flexible, and easy to use prognostic system.
References
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Book
AJCC Cancer Staging Manual
Mahul B. Amin,Stephen B. Edge,Frederick L. Greene,David R. Byrd,Robert K. Brookland,Mary Kay Washington,Jeffrey E. Gershenwald,Carolyn C. Compton,Kenneth R. Hess,Daniel C. Sullivan,J. Milburn Jessup,James D. Brierley,Lauri E. Gaspar,Richard L. Schilsky,Charles M. Balch,David P. Winchester,Elliot A. Asare,Martin Madera,Donna M. Gress,Laura R. Meyer +19 more
TL;DR: Purposes and Principles of Cancer Staging and End-Results Reporting are explained.
Journal ArticleDOI
The patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity.
TL;DR: A retrospective review of the records of 501 previously untreated patients with squamous cell carcinoma of the oral cavity was undertaken to ascertain the prevalence of ipsilateral neck node metastases (NM) by neck level, and data support the trend toward selective limited neck dissection in both NO and N+ patients.
Journal ArticleDOI
Colon Cancer Survival Is Associated With Decreasing Ratio of Metastatic to Examined Lymph Nodes
Adam C. Berger,Elin R. Sigurdson,Thomas Levoyer,Alexandra L. Hanlon,Robert J. Mayer,John S. Macdonald,Paul J. Catalano,Daniel G. Haller +7 more
TL;DR: After curative resection for colorectal cancer, the LNR is an important prognostic factor and should be used in stratification schemes for future clinical trials investigating adjuvant treatments.
Colon cancer survival is associated with decreasing ratio of metastatic to examined lymph nodes
Adam C. Berger,Elin R. Sigurdson,Thomas Levoyer,Alexandra L. Hanlon,Robert J. Mayer,John S. Macdonald,Paul J. Catalano,Daniel G. Haller +7 more
TL;DR: In this paper, the authors analyzed data from Intergroup trial 0089 of adjuvant chemotherapy for stage II and III patients with colon cancer, in which all patients received fluorouracil-based therapy.
Journal ArticleDOI
Inflation of the type I error rate when a continuous confounding variable is categorized in logistic regression analyses.
TL;DR: It is found that the inflation of the type I error rate increases with increasing sample size, as the correlation between the risk factor and the confounding variable increases, and with a decrease in the number of categories into which the confounder is divided.
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Lymph node density in oral cavity cancer: Results of the International Consortium for Outcomes Research
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