淋巴结比率作为转移性头颈部皮肤鳞状细胞癌的一个预后因素。
Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma.
作者信息
Vasan Kartik, Low Tsu-Hui Hubert, Gupta Ruta, Ashford Bruce, Asher Rebecca, Gao Kan, Ch'ng Sydney, Palme Carsten E, Clark Jonathan R
机构信息
Nepean Blue Mountains Local Health District, Sydney, Australia.
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, Australia.
出版信息
Head Neck. 2018 May;40(5):993-999. doi: 10.1002/hed.25066. Epub 2018 Jan 23.
BACKGROUND
The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC.
METHODS
A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold.
RESULTS
Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P = .01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis.
CONCLUSION
The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.
背景
头颈部皮肤鳞状细胞癌（SCC）中淋巴结转移的大小和数量对预后的影响已得到充分证实。本研究的目的是验证转移的头颈部皮肤SCC中淋巴结比率的预后意义。
方法
对326例伴有腮腺和/或颈部淋巴结转移的头颈部皮肤SCC患者进行回顾性研究。主要终点为总生存期（OS）和无病生存期（DFS）。采用最小P值法研究最佳淋巴结比率阈值。
结果
我们的数据包括77例复发和101例死亡。在多变量分析中，淋巴结比率为6%是DFS缩短（风险比[HR]1.62；95%置信区间[CI]1.11 - 2.38；P = 0.01）和OS缩短（HR 1.63；95% CI 1.03 - 2.58；P = 0.04）的显著预测因素。
结论
淋巴结比率是转移性头颈部皮肤SCC患者生存结局的独立预后指标。淋巴结比率>6%是将患者分为低风险和高风险的重要阈值。
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