Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Eur J Surg Oncol. 2019 Jun;45(6):1025-1032. doi: 10.1016/j.ejso.2018.11.008. Epub 2018 Nov 15.
INTRODUCTION: To investigate whether the positive lymph node number (PLNN) and positive lymph node ratio (PLNR) could predict the prognosis of patients with major salivary gland cancer (MSGC) and to identify the optimal cutoff points for these variables that stratify patients according to their risk of survival. METHODS: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify all patients with MSGC between 1988 and 2014. A logistic regression analysis was carried out to evaluate the risk factors for lymph node metastasis (LNM) in MSGC. The X-tile program was used to identify the cutoff values for the PLNN and PLNR in MSGC patients with LNM. Cox proportional hazards regression models were performed to identify the predictors of cancer-specific survival (CSS). RESULTS: In the SEER database, 8668 eligible patients were identified and 3046 of them had LNM. The logistic regression analysis indicated that older age, male sex, larger tumor size, higher grade, tumor extension and high-risk pathology were associated with LNM. The X-tile program showed that a PLNN>4 and a PLNR>0.15 were prognostic indicators of CSS. A multivariable analysis indicated that, after the factors that might potentially affect the prognosis were adjusted for, the PLNN and PLNR were still associated with CSS. CONCLUSIONS: Our Results demonstrated that the PLNN and PLNR were independent prognostic indicators for MSGC patients with lymph node metastasis.
简介:为了研究阳性淋巴结数(PLNN)和阳性淋巴结比(PLNR)是否可以预测大涎腺癌(MSGC)患者的预后,并确定这些变量的最佳截断值,以便根据患者的生存风险对其进行分层。 方法:我们使用监测、流行病学和最终结果(SEER)数据库,确定了 1988 年至 2014 年间所有患有 MSGC 的患者。通过逻辑回归分析评估了 MSGC 患者发生淋巴结转移(LNM)的危险因素。使用 X-tile 程序确定了具有 LNM 的 MSGC 患者的 PLNN 和 PLNR 的截断值。采用 Cox 比例风险回归模型确定癌症特异性生存(CSS)的预测因素。 结果:在 SEER 数据库中,确定了 8668 名符合条件的患者,其中 3046 名患者发生了 LNM。逻辑回归分析表明,年龄较大、男性、肿瘤较大、较高分级、肿瘤扩展和高危病理学与 LNM 相关。X-tile 程序显示,PLNN>4 和 PLNR>0.15 是 CSS 的预后指标。多变量分析表明,在调整了可能影响预后的因素后,PLNN 和 PLNR 仍然与 CSS 相关。 结论:我们的研究结果表明,PLNN 和 PLNR 是 MSGC 伴淋巴结转移患者的独立预后指标。
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