Iyer Varuni, Kumar Kiran, Hallikeri Kaveri, Desai Anil Kumar, Kumar Niranjan, Natarajan Srikant
Department of Oral Pathology and Microbiology, SDM College of Dental Sciences and Hospital, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India.
SDM Craniofacial Surgery and Research Centre, A Constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India.
J Oral Maxillofac Pathol. 2020 Sep-Dec;24(3):576. doi: 10.4103/jomfp.JOMFP_110_20. Epub 2021 Jan 9.
Log odds of positive lymph nodes (LODDS) have been recently demonstrated as a very promising staging model and have outperformed AJCC pN, lymph node ratio (LNR) category in major cancers. Literature is scarce concerning the prognostic ability of LODDS in oral squamous cell carcinoma (OSCC) patients.
The present study was aimed to evaluate the importance of LODDS in predicting locoregional recurrence and overall survival (OS) in patients with OSCC compared to LNR.
The retrospective study was carried out on 194 patients with OSCC cases treated by surgery ± adjuvant therapy from 2008 to 2014 at our institution.
Demographical and clinicopathological details of study cases were recorded. LNR and LODDS were calculated and expressed as a percentage and mean ± standard deviation.
The OS analysis was done by the Kaplan-Meier curve followed by log-rank (mantel-cox) test. Univariate and multivariate survival analysis was done to analyze the prognostic ability of LNR% and LODDS after adjusting the clinicopathological parameters by the Cox proportional hazards model.
Patients with cut off values of LODDS >-1.2 and LNR% >4 had significantly lower mean OS ( ≤ 0.001). Multivariate analysis indicated that only mean LODDS >-1.2 was significantly associated with poor OS. Although there was a correlation with locoregional recurrence, LODDS and LNR failed to be the independent predictors of locoregional recurrence.
LODDS was an independent reliable prognostic indicator for patients with OSCCs than conventional staging systems and LNR.
阳性淋巴结对数比值（LODDS）最近已被证明是一种非常有前景的分期模型，在主要癌症中其表现优于美国癌症联合委员会（AJCC）的pN分期、淋巴结比率（LNR）分类。关于LODDS在口腔鳞状细胞癌（OSCC）患者中的预后能力的文献较少。
本研究旨在评估与LNR相比，LODDS在预测OSCC患者局部区域复发和总生存期（OS）方面的重要性。
本回顾性研究对2008年至2014年在我院接受手术±辅助治疗的194例OSCC患者进行。
记录研究病例的人口统计学和临床病理详细信息。计算LNR和LODDS，并以百分比和均值±标准差表示。
采用Kaplan-Meier曲线进行OS分析，随后进行对数秩（曼特尔-考克斯）检验。通过Cox比例风险模型调整临床病理参数后，进行单因素和多因素生存分析，以分析LNR%和LODDS的预后能力。
LODDS > -1.2且LNR% > 4的患者的平均OS显著较低（≤ 0.001）。多因素分析表明，只有平均LODDS > -1.2与较差的OS显著相关。尽管与局部区域复发存在相关性，但LODDS和LNR未能成为局部区域复发的独立预测因素。
与传统分期系统和LNR相比，LODDS是OSCC患者独立可靠的预后指标。
