He Changding, Heng Yu, Zhu Xiaoke, Zhou Jian, Tao Lei
Fudan University, Department of Otorhinolaryngology, Eye and ENT Hospital, Shanghai, China.
Fudan University, Department of Otorhinolaryngology, Eye and ENT Hospital, Shanghai, China.
Braz J Otorhinolaryngol. 2025 Mar-Apr;91(2):101535. doi: 10.1016/j.bjorl.2024.101535. Epub 2024 Nov 18.
To identify risk factors for Lymph Node Metastasis (LNM) in pT3-4 Laryngeal Squamous Cell Carcinoma (LSCC) patients with negative margins, and develop a nomogram to predict LNM risk.
872 patients were divided into training (2010-2014) and validation (2015-2016) cohorts. Univariate and multivariate analyses identified LNM risk factors. A nomogram incorporating significant factors was developed in the training cohort.
Smoking history, maximal tumor diameter ≥3.0 cm, depth of tumor invasion >1.0 cm, and supraglottic tumor location were significantly associated with LNM on multivariate analysis. A predictive nomogram incorporating these factors showed good discrimination (C-index > 0.7) in both cohorts. Patients were stratified into low, moderate and high-risk subgroups based on total risk scores.
A LNM risk prediction model and risk grouping system was established, which may aid treatment selection for pT3-4 LSCC patients. The model and algorithm could help optimize neck management for this high-risk patient population.
确定切缘阴性的pT3-4期喉鳞状细胞癌（LSCC）患者发生淋巴结转移（LNM）的危险因素，并建立一种列线图以预测LNM风险。
872例患者被分为训练队列（2010 - 2014年）和验证队列（2015 - 2016年）。单因素和多因素分析确定LNM的危险因素。在训练队列中建立包含显著因素的列线图。
多因素分析显示，吸烟史、最大肿瘤直径≥3.0 cm、肿瘤浸润深度>1.0 cm和声门上肿瘤位置与LNM显著相关。包含这些因素的预测列线图在两个队列中均显示出良好的区分度（C指数>0.7）。根据总风险评分将患者分为低、中、高风险亚组。
建立了LNM风险预测模型和风险分组系统，这可能有助于pT3-4期LSCC患者的治疗选择。该模型和算法有助于优化对这一高危患者群体的颈部管理。
