Jang Jeon Yeob, Kim Min Ji, Ryu Gwanghui, Choi Nayeon, Ko Young-Hyeh, Jeong Han-Sin
Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
Cancer Res Treat. 2016 Jan;48(1):54-62. doi: 10.4143/crt.2014.332. Epub 2015 Mar 6.
Lymph node metastasis (LNM) is a strong prognostic factor in many solid cancers, including head and neck squamous cell carcinomas (HNSCC), and LNM can be dependent upon primary tumor biology, as well as tumor dimension. Here, we investigate the relative risk of LNM in accordance to tumor dimension and biology in HNSCC subsites.
Medical data of 295 HNSCC patients who had undergone the initial curative surgery (oral tongue 174, oropharynx 75, hypopharynx 46) were analyzed to identify the significant predictive factor for LNM. Tumor volume and thickness were set as tumor dimensional variables, and biological variables included lymphovascular, perineural invasion, and tumor differentiation. Statistical analyses were conducted to assess the predictability of LNM from variables, and subgroup analyses according to the tumor subsites. In addition, we evaluated the impacts of tumor dimension and biological variables on the treatment outcomes and survival in HNSCC subsites.
The overall tumor dimension and biological variables had a similar impact on the prediction of LNM in HNSCC (area under the curve, 0.7682 and 0.7717). The prediction sensitivity of LNM in oral tongue cancer was mainly dependent on tumor dimension, while LNM in oro- and hypo-pharynx cancers was more influenced by biological factors. Survival analyses also confirmed that biological factor was more powerful in estimating disease-free survival of hypopharyngeal cancer patients, while tumor dimension was more significant in that of oral cancer patients.
Tumor dimension and biology have a significant, tumor subsite-dependent impact on the occurrence of LNM and disease-free survival in HNSCC.
淋巴结转移（LNM）是包括头颈部鳞状细胞癌（HNSCC）在内的许多实体癌的一个强有力的预后因素，LNM可能取决于原发肿瘤生物学特性以及肿瘤大小。在此，我们根据HNSCC亚部位的肿瘤大小和生物学特性来研究LNM的相对风险。
分析295例接受了初次根治性手术的HNSCC患者（舌癌174例、口咽癌75例、下咽癌46例）的医学数据，以确定LNM的显著预测因素。将肿瘤体积和厚度设定为肿瘤大小变量，生物学变量包括淋巴管、神经周围侵犯以及肿瘤分化程度。进行统计分析以评估变量对LNM的预测能力，并根据肿瘤亚部位进行亚组分析。此外，我们评估了肿瘤大小和生物学变量对HNSCC亚部位治疗结果和生存的影响。
总体肿瘤大小和生物学变量对HNSCC中LNM的预测影响相似（曲线下面积分别为0.7682和0.7717）。舌癌中LNM的预测敏感性主要取决于肿瘤大小，而口咽癌和下咽癌中的LNM受生物学因素影响更大。生存分析也证实，生物学因素在评估下咽癌患者无病生存方面更强有力，而肿瘤大小在评估口腔癌患者无病生存方面更显著。
肿瘤大小和生物学特性对HNSCC中LNM的发生及无病生存有显著的、取决于肿瘤亚部位的影响。
