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
Department of Radiation Oncology, Emory University, Atlanta, Georgia.
Winship Cancer Institute, Emory University, Atlanta, Georgia.
Head Neck. 2015 Jun;37(6):777-82. doi: 10.1002/hed.23662. Epub 2014 Apr 30.
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.
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.
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).
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.
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。
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。
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）。
在校正病理因素和辅助治疗后，发现淋巴结比率是局部区域复发和总生存期（OS）的独立预后因素。淋巴结比率≥20%的患者局部区域复发和死亡风险高，可考虑辅助放化疗。
