Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts.
Head Neck. 2019 Nov;41(11):3895-3905. doi: 10.1002/hed.25927. Epub 2019 Aug 30.
We investigated the impact of level I lymph node involvement (LNI) on survival for patients with oropharyngeal squamous cell carcinoma (OPSCC).
We performed a cohort study of patients with OPSCC who underwent resection with known human papillomavirus (HPV) status in the National Cancer Database (2010-2014).
Among 5591 patients with OPSCC, 599 (10.7%) had level I LNI. Predictors of level I LNI included pT classification (pT3 vs pT1; odds ratio [OR], 1.95; P < 0.001), pN classification (pN3 vs pN1; OR, 1.63; P = 0.05), and level III LNI (OR, 6.05; P < 0.001). Among included patients, 4035 had known survival status. Level I LNI predicted inferior overall survival (OS) while adjusting for covariates (HR, 1.64; P < 0.001). Subset analyses revealed association between level I LNI and inferior OS among patients with base of tongue cancer, pT/pN classification greater than 1, and HPV-negative cancer.
Level I LNI predicts inferior OS, particular among patients with at least pT2 or pN2 OPSCC.
我们研究了 I 级淋巴结受累（LNI）对口咽鳞状细胞癌（OPSCC）患者生存的影响。
我们在国家癌症数据库（2010-2014 年）中进行了一项 OPSCC 患者切除术队列研究，这些患者的人乳头瘤病毒（HPV）状态已知。
在 5591 例 OPSCC 患者中，599 例（10.7%）存在 I 级 LNI。I 级 LNI 的预测因素包括 pT 分类（pT3 比 pT1；优势比 [OR]，1.95；P<0.001）、pN 分类（pN3 比 pN1；OR，1.63；P=0.05）和 III 级 LNI（OR，6.05；P<0.001）。在纳入的患者中，4035 例有已知的生存状态。在校正协变量后，I 级 LNI 预测总生存（OS）不良（HR，1.64；P<0.001）。亚组分析显示，在舌根癌、pT/pN 分类大于 1 和 HPV 阴性癌症患者中，I 级 LNI 与 OS 不良之间存在关联。
I 级 LNI 预测 OS 不良，尤其是在至少患有 pT2 或 pN2 OPSCC 的患者中。
