Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Sci Rep. 2017 Oct 26;7(1):14117. doi: 10.1038/s41598-017-06452-0.
To compare the prognostic value of 3 different lymph node scoring systems " log odds of positive nodes (LODDS), lymph node ratio (rN), and lymph node yield " in an effort to improve the staging of oral cancer. We identified 3958 oral cancer patients from Surveillance, Epidemiology, and End Results database from 2007 to 2013. In univariate analysis, LODDS, pN, rN, and lymph node yield were prognostic factors for 5-year disease-specific survival (DSS) and overall survival (OS). Multivariate analysis indicated that patients with LODDS 4 had worst 5-year DSS and OS. Stage migration occurred in pN1 and pN2 patients with LODDS 4. In pN1 patients, those with LODDS 4 had the worst 5-year DSS (41.2%) and OS (31.6%) than patients with pN1 and LODDS 2-3. In pN2 patients, those with LODDS4 had the worst 5-year DSS (34.5%) and OS (27.4%) than patients with pN2 and LODDS 2-3. The proposed staging system, which incorporates LODDS with AJCC pN, had better discriminability and prediction accuracy for predicting survival. We also noted that patients with LODDS 4 given adjuvant radiotherapy had better 5-year DSS and OS. The LODDS should be considered as a future candidate measurement for N category in oral cancer.
为了比较 3 种不同的淋巴结评分系统（对数阳性淋巴结比（LODDS）、淋巴结比率（rN）和淋巴结检出量）在口腔癌分期中的预后价值，以改善口腔癌的分期。我们从 2007 年至 2013 年的监测、流行病学和最终结果数据库中确定了 3958 名口腔癌患者。在单因素分析中，LODDS、pN、rN 和淋巴结检出量是 5 年疾病特异性生存率（DSS）和总生存率（OS）的预后因素。多因素分析表明，LODDS 为 4 的患者 5 年 DSS 和 OS 最差。pN1 和 pN2 患者的分期迁移发生在 LODDS4 患者中。在 pN1 患者中，LODDS4 的患者 5 年 DSS（41.2%）和 OS（31.6%）比 pN1 和 LODDS2-3 的患者差。在 pN2 患者中，LODDS4 的患者 5 年 DSS（34.5%）和 OS（27.4%）比 pN2 和 LODDS2-3 的患者差。纳入 AJCC pN 的 LODDS 的拟议分期系统在预测生存方面具有更好的区分度和预测准确性。我们还注意到，接受辅助放疗的 LODDS4 患者的 5 年 DSS 和 OS 更好。LODDS 应被视为口腔癌 N 分期的未来候选测量指标。
