Can metastatic lymph node ratio (LNR) predict survival in oral cavity cancer patients?. Issue 4 (24th July 2013)

• Record Type: Journal Article
• Authors: Sayed, Suhail I.; Sharma, Shilpi; Rane, Pawan; Vaishampayan, Sagar; Talole, Sanjay; Chaturvedi, Pankaj; Chaukar, Devendra; Deshmukh, Anuja; Agarwal, Jai Prakash; D'cruz, Anil K.
• Is Part Of: Journal of surgical oncology. Volume 108:Issue 4(2013:Sep. 15)
• Page Start: 256
• Page End: 263
• Publication Date: 2013-07-24
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23387
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23387-sec-0001" sec-type="section"> <title>Objectives</title> <p>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.</p> </sec> <sec id="jso23387-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="jso23387-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> < 0.001). On multivariate analysis LNR of 0.088 was seen to be an independent prognostic factor for 5‐year regional control (<italic>p, hazard ratio [95% confidence interval]</italic>; 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.</p> </sec> <sec id="jso23387-sec-0004" sec-type="section"> <title>Conclusions</title> <p>LNR is a better prognostic marker than the current N staging of TNM classification. <italic>J. Surg. Oncol. 2013 108:256–263</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>