淋巴结比率对初次手术切除后头颈癌局部区域复发风险的影响：对辅助治疗的启示

Lymph node ratio influence on risk of head and neck cancer locoregional recurrence after initial surgical resection: implications for adjuvant therapy.

作者信息

Prabhu Roshan S, Hanasoge Sheela, Magliocca Kelly R, Hall William A, Chen Susie A, Higgins Kristin A, Saba Nabil F, El-Deiry Mark, Grist William, Wadsworth J Trad, Chen Amy Y, Beitler Jonathan J

机构信息

Department of Radiation Oncology, Emory University, Atlanta, Georgia.

Winship Cancer Institute, Emory University, Atlanta, Georgia.

出版信息

Head Neck. 2015 Jun;37(6):777-82. doi: 10.1002/hed.23662. Epub 2014 Apr 30.

DOI:10.1002/hed.23662

PMID:24596123

Abstract

BACKGROUND

The purpose of this study was to determine if lymph node ratio is associated with locoregional recurrence for patients with oral cavity or laryngeal cancer treated with initial surgical management.

METHODS

The study included 350 patients with oral cavity (73%) or laryngeal cancer (27%) who underwent initial surgery. All analyses were multivariable, adjusting for primary site, pathologic prognostic factors, and adjuvant therapy.

RESULTS

Lymph node ratio was significantly associated with locoregional recurrence, in which each 1% increase in lymph node ratio had an adjusted hazard ratio (HR) for locoregional recurrence of 1.02 (95% confidence interval [CI], 1.002-1.042; p = .05). Lymph node ratio was also associated with OS, in which each 1% increase in lymph node ratio had an adjusted HR for death of 1.028 (95% CI, 1.012-1.045; p = .001).

CONCLUSION

Adjusting for pathologic factors and adjuvant therapy, lymph node ratio was found to be an independent prognostic factor for locoregional recurrence and overall survival (OS). Patients with lymph node ratio ≥20% are at high risk of locoregional recurrence and death, and may be considered for adjuvant chemoradiation.

摘要

背景

本研究旨在确定淋巴结比率是否与接受初始手术治疗的口腔或喉癌患者的局部区域复发相关。

方法

该研究纳入了350例接受初始手术的口腔癌患者（73%）或喉癌患者（27%）。所有分析均为多变量分析，并对原发部位、病理预后因素和辅助治疗进行了校正。

结果

淋巴结比率与局部区域复发显著相关，淋巴结比率每增加1%，局部区域复发的校正风险比（HR）为1.02（95%置信区间[CI]，1.002 - 1.042；p = 0.05）。淋巴结比率也与总生存期（OS）相关，淋巴结比率每增加1%，死亡的校正HR为1.028（95% CI，1.012 - 1.045；p = 0.001）。