University of Sao Paulo School of Medicine, Head and Neck Surgery, Av. Conselheiro Nébias, 444, conj. 1605, Santos, SP, 11045-000, Brazil.
Department of Head and Neck Surgery, Cancer Institute of São Paulo ICESP, São Paulo, Brazil.
Eur Arch Otorhinolaryngol. 2020 Mar;277(3):833-840. doi: 10.1007/s00405-020-05789-z. Epub 2020 Jan 29.
The lymph node density (LND) is the number of positive metastatic lymph nodes divided by the total number of dissected lymph nodes. The purpose of this study was to evaluate LND as a prognostic factor in patients with laryngeal squamous cell carcinoma (SCC).
The study included 186 patients with laryngeal SCC submitted to laryngeal surgical treatment with neck dissection between January 2009 and December 2016. Clinical-pathological variables were assessed, as well as the cut-off point for LND.
LND value was calculated considering pN+ (LND = 0.060). The Kaplan-Meier curve (log-rank) related to cumulative survival demonstrated that patients with LND ≥ 0.060 had a higher mortality rate than those with LND < 0.060, presenting a more aggressive form of the disease, with earlier recurrence. However, only the LND ≥ 0.060 group had impact on both disease-free survival and overall survival.
The LND proved to be an important index in the prognostic evaluation of larynx SCC patients having a direct relationship with disease recurrence. Patients with LND ≥ 0.060 should be considered for adjuvant therapy.
淋巴结密度（LND）是阳性转移淋巴结的数量除以解剖淋巴结的总数。本研究旨在评估 LND 作为喉鳞状细胞癌（SCC）患者的预后因素。
本研究纳入了 186 例 2009 年 1 月至 2016 年 12 月期间接受喉外科治疗和颈部淋巴结清扫术的喉 SCC 患者。评估了临床病理变量以及 LND 的截止值。
考虑到 pN+（LND=0.060），计算了 LND 值。与累积生存率相关的 Kaplan-Meier 曲线（对数秩）表明，LND≥0.060 的患者死亡率高于 LND<0.060 的患者，表现出更具侵袭性的疾病形式，复发更早。然而，只有 LND≥0.060 组对无病生存率和总生存率有影响。
LND 被证明是评估喉 SCC 患者预后的重要指标，与疾病复发有直接关系。LND≥0.060 的患者应考虑辅助治疗。
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