Jiang Wen-Mei, Xu Jian-Feng, Chen Jun, Li Guo-Li, Gao Yun-Fei, Zhang Quan, Chen Yan-Feng
Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
Department of Surgery, Dongguan Third Bureau Hospital, Dongguan City, Guangdong, China.
Front Surg. 2022 May 11;9:903576. doi: 10.3389/fsurg.2022.903576. eCollection 2022.
BACKGROUND: Lymph node ratio (LNR) has been reported to reliably predict cancer-specific survival (CSS) in parotid gland cancer (PGC). Our study was designed to validate the significance of LNR in patients with PGC. METHODS: Patients diagnosed with stage I-IV PGC were enrolled from Surveillance Epidemiology and End Results database (SEER, = 3529), which is the training group, and Sun Yat-sen University Cancer Center database (SYSUCC, = 99), the validation group. We used X-tile software to choose the optimal cutoff value of LNR; then, univariable and multivariable analyses were performed, assessing the association between LNR and CSS. RESULTS: The optimal cutoff value of LNR was 0.32 by X-tile based on 3529 patients from SEER. Cox proportional hazard regression analysis revealed better CSS for patients with LNR ≤ 0.32 (adjusted hazard ratio [HR] 1.612, 95% confidence interval [95% CI] 1.286-2.019; < 0.001) compared with patients with LNR > 0.32 in SEER. In the SYSUCC cohort, patients with LNR ≤ 0.32 also had better CSS over patients with LNR > 0.32 ( < 0.001). In N2 and N3 stage groups, patients with LNR ≤ 0.32 had superior CSS outcomes over those with the LNR > 0.32 group, but this benefit was absent in the N1 stage group. CONCLUSIONS: In conclusion, the lymph node ratio turned out to be an independent prognostic factor for cancer-specific survival of PGC in this study. This valuable information could help clinicians to evaluate the prognosis of PGC and suggest that adequate lymph node dissection is necessary.
背景:据报道,淋巴结比率(LNR)能够可靠地预测腮腺癌(PGC)患者的癌症特异性生存率(CSS)。我们的研究旨在验证LNR在PGC患者中的意义。 方法:从监测、流行病学和最终结果数据库(SEER,n = 3529)纳入诊断为Ⅰ-Ⅳ期PGC的患者作为训练组,从中山大学肿瘤防治中心数据库(SYSUCC,n = 99)纳入患者作为验证组。我们使用X-tile软件选择LNR的最佳临界值;然后进行单变量和多变量分析,评估LNR与CSS之间的关联。 结果:基于SEER的3529例患者,X-tile得出LNR的最佳临界值为0.32。Cox比例风险回归分析显示,在SEER中,LNR≤0.32的患者比LNR>0.32的患者具有更好的CSS(调整后风险比[HR] 1.612,95%置信区间[95%CI] 1.286 - 2.019;P < 0.001)。在SYSUCC队列中,LNR≤0.32的患者也比LNR>0.32的患者具有更好的CSS(P < 0.001)。在N2和N3期组中,LNR≤0.32的患者比LNR>0.32组具有更好的CSS结果,但在N1期组中没有这种优势。 结论:总之,在本研究中,淋巴结比率被证明是PGC患者癌症特异性生存的独立预后因素。这一有价值的信息可帮助临床医生评估PGC的预后,并提示充分的淋巴结清扫是必要的。
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