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口腔癌中的淋巴结密度：国际结局研究联合会的研究结果。

Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research.

机构信息

Head and Neck Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Br J Cancer. 2013 Oct 15;109(8):2087-95. doi: 10.1038/bjc.2013.570. Epub 2013 Sep 24.

DOI:10.1038/bjc.2013.570
PMID:24064974
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3798966/
Abstract

BACKGROUND

Lymph node density (LND) has previously been reported to reliably predict recurrence risk and survival in oral cavity squamous cell carcinoma (OSCC). This multicenter international study was designed to validate the concept of LND in OSCC.

METHODS

The study included 4254 patients diagnosed as having OSCC. The median follow-up was 41 months. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), locoregional control and distant metastasis rates were calculated using the Kaplan-Meier method. Lymph node density (number of positive lymph nodes/total number of excised lymph nodes) was subjected to multivariate analysis.

RESULTS

The OS was 49% for patients with LND0.07 compared with 35% for patients with LND>0.07 (P<0.001). Similarly, the DSS was 60% for patients with LND0.07 compared with 41% for those with LND>0.07 (P<0.001). Lymph node density reliably stratified patients according to their risk of failure within the individual N subgroups (P=0.03). A modified TNM staging system based on LND ratio was consistently superior to the traditional system in estimating survival measures.

CONCLUSION

This multi-institutional study validates the reliability and applicability of LND as a predictor of outcomes in OSCC. Lymph node density can potentially assist in identifying patients with poor outcomes and therefore for whom more aggressive adjuvant treatment is needed.

摘要

背景

淋巴结密度（LND）先前已被报道可可靠地预测口腔鳞状细胞癌（OSCC）的复发风险和生存情况。本多中心国际研究旨在验证 LND 在 OSCC 中的概念。

方法

该研究纳入了 4254 例诊断为 OSCC 的患者。中位随访时间为 41 个月。使用 Kaplan-Meier 方法计算 5 年总生存率（OS）、疾病特异性生存率（DSS）、无病生存率（DFS）、局部区域控制率和远处转移率。对淋巴结密度（阳性淋巴结数/切除淋巴结总数）进行多变量分析。

结果

LND≤0.07 患者的 OS 为 49%，而 LND>0.07 患者的 OS 为 35%（P<0.001）。同样，LND≤0.07 患者的 DSS 为 60%，而 LND>0.07 患者的 DSS 为 41%（P<0.001）。淋巴结密度可根据个体 N 亚组内的失败风险可靠地区分患者（P=0.03）。基于 LND 比值的改良 TNM 分期系统在估计生存指标方面始终优于传统系统。

结论

这项多机构研究验证了 LND 作为 OSCC 结局预测指标的可靠性和适用性。淋巴结密度有可能有助于识别预后不良的患者，因此需要更积极的辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/050134178fc9/bjc2013570f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/46c30b3f0ec7/bjc2013570f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/41e2da31793a/bjc2013570f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/d4e9136137e0/bjc2013570f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/050134178fc9/bjc2013570f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/46c30b3f0ec7/bjc2013570f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/41e2da31793a/bjc2013570f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/d4e9136137e0/bjc2013570f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8acb/3798966/050134178fc9/bjc2013570f4.jpg

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