Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China.
Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, China.
Eur J Surg Oncol. 2023 Aug;49(8):1405-1410. doi: 10.1016/j.ejso.2023.04.002. Epub 2023 Apr 11.
Survival significance of parotid lymph node (LN) factors in parotid cancer remains unclear, our goal was to assess the impact of number, size, and extranodal extension (ENE) of metastatic parotid LNs on prognosis in parotid cancer.
Patients with surgically treated parotid cancer were retrospectively enrolled. Primary outcome variable was recurrence-free survival (RFS) and overall survival (OS). The hazard ratios (HRs) of main predictive variables including the number, size, and ENE of positive parotid LNs on RFS and OS were analyzed using Cox model. The secondary outcome variable was ENE of metastatic parotid LN, its association with clinicopathologic variables were evaluated using Chi-square test.
In total, 453 patients (186 male and 267 female) were included. The 10-year RFS and OS rates were 73% (95%CI: 69%-77%) and 61% (95%CI: 55%-67%), respectively. In Cox model, compared none parotid LN metastasis, one metastatic parotid LN did not offer additional compromise of RFS (p = 0.224) or OS (p = 0.135), but two or more positive LNs decreased the control of RFS (HR: 2.017; 95%CI: 1.378-4.632) and OS (HR: 2.173; 95%CI: 1.367-4.275). When accounting for the number of metastatic LNs, LN size or ENE was no longer related to RFS or OS. ENE of parotid LN tended to develop if there was presence of T3/4 stage, lymphovascular invasion, high histologic grade, N2/3 stage, and three or more positive parotid LNs.
Quantitative parotid LN burden but not ENE or LN size is an important determinant of survival in patients with parotid cancer.
腮腺淋巴结（LN）因素对腮腺癌生存的意义仍不清楚，我们的目标是评估转移性腮腺 LN 的数量、大小和结外扩展（ENE）对腮腺癌预后的影响。
回顾性纳入接受手术治疗的腮腺癌患者。主要观察变量是无复发生存（RFS）和总生存（OS）。使用 Cox 模型分析包括阳性腮腺 LN 数量、大小和 ENE 在内的主要预测变量对 RFS 和 OS 的风险比（HR）。次要观察变量为转移性腮腺 LN 的 ENE，使用卡方检验评估其与临床病理变量的关系。
共纳入 453 例患者（男 186 例，女 267 例）。10 年 RFS 和 OS 率分别为 73%（95%CI：69%-77%）和 61%（95%CI：55%-67%）。在 Cox 模型中，与无腮腺 LN 转移相比，单个转移性腮腺 LN 并未进一步降低 RFS（p=0.224）或 OS（p=0.135），但两个或更多阳性 LNs 降低了 RFS（HR：2.017；95%CI：1.378-4.632）和 OS（HR：2.173；95%CI：1.367-4.275）的控制率。当考虑转移性 LNs 的数量时，LN 大小或 ENE 与 RFS 或 OS 不再相关。如果存在 T3/4 期、血管淋巴管侵犯、高组织学分级、N2/3 期和 3 个或更多阳性腮腺 LN，则腮腺 LN 的 ENE 更易发生。
腮腺 LN 的定量负荷而不是 ENE 或 LN 大小是腮腺癌患者生存的重要决定因素。
