评估淋巴结比率和淋巴结收获量作为p16相关口咽鳞状细胞癌局部区域复发预后指标的价值。
Evaluation of lymph node ratio and lymph node yield as prognosticators of locoregional recurrence in p16-associated oropharyngeal squamous cell carcinoma.
作者信息
Nurimba Margaret, Hines William, Sinha Uttam, Mathew Anna, Kokot Niels, Swanson Mark
机构信息
Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
出版信息
Head Neck. 2020 Oct;42(10):2811-2820. doi: 10.1002/hed.26324. Epub 2020 Jun 16.
BACKGROUND
The prognostic value of lymph node yield (LNY) and lymph node ratio (LNR), or the ratio of number of metastatic LNs to total number dissected, has not been well established in p16-associated oropharyngeal squamous cell carcinoma (OPSCC).
METHODS
This retrospective cohort study evaluated locoregional disease-free survival (LRDFS) in 82 patients with p16+ OPSCC who underwent neck dissection at a single institution from 2009 to 2017. LNR and LNY cutoffs were estimated using time-dependent receiver operator characteristic (ROC) curves. Prognostic significance of these cutoffs was compared with Eighth Edition AJCC Nodal Staging.
RESULTS
An increased LNR ≥ 0.129 was associated with worse 2-year LRDFS (66.9% vs 96.8%, P = .005). LNY was not significantly associated with LRDFS (P = .304). An LNR-based risk model was a better prognosticator than Eighth Edition AJCC Nodal Staging (Harrell's C, 0.9065 vs 0.7668).
CONCLUSIONS
LNR has good prognostic utility in predicting LRDFS in p16+ OPSCC, but further evaluation of this measure is warranted.
背景
在p16相关的口咽鳞状细胞癌（OPSCC）中，淋巴结收获量（LNY）和淋巴结比率（LNR，即转移淋巴结数量与清扫的总淋巴结数量之比）的预后价值尚未明确。
方法
这项回顾性队列研究评估了2009年至2017年在单一机构接受颈部清扫术的82例p16阳性OPSCC患者的局部区域无病生存期（LRDFS）。使用时间依赖性受试者工作特征（ROC）曲线估计LNR和LNY的临界值。将这些临界值的预后意义与美国癌症联合委员会（AJCC）第八版淋巴结分期进行比较。
结果
LNR≥0.129升高与较差的2年LRDFS相关（66.9%对96.8%，P = 0.005）。LNY与LRDFS无显著相关性（P = 0.304）。基于LNR的风险模型比AJCC第八版淋巴结分期具有更好的预后预测能力（Harrell氏C指数，0.9065对0.7668）。
结论
LNR在预测p16阳性OPSCC的LRDFS方面具有良好的预后效用，但有必要对该指标进行进一步评估。
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