Wang Tian, Zhang Duo, Hsueh Chiyao, Lau Hui-Ching, Tao Lei, Wu Chunping
Department of Radiation Oncology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
Department of Otorhinolaryngology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
J Craniomaxillofac Surg. 2025 Apr;53(4):340-346. doi: 10.1016/j.jcms.2024.12.017. Epub 2025 Jan 6.
Lymph node ratio (LNR), log odds of positive lymph nodes (LODDS), and the number of postoperative lymph node staging (pN) are prognostic indicators of various cancers. However, the prognostic values of these indicators remain unclear in hypopharyngeal squamous cell carcinoma (HPSCC). This study's primary objective was to investigate the predictive value of LNR, LODDS, and pN for advanced HPSCC, and the secondary objective was to compare which of the values had the best predictive value for advanced HPSCC.
A retrospective study was conducted on 166 patients with stage Ⅲ-Ⅳ HPSCC. LNR and LODDS were divided into two groups according to the defined cut-off values. Univariate and multivariate analyses on the risk of overall survival (OS) and progression-free survival (PFS) were performed, respectively. The predictive value of LNR was compared with that of LODDS and pN using receiver operating characteristic (ROC) curves.
According to the X-tile, the cut-off values are 0.11 for LNR and -0.91 for LODDS. LNR, LODDS, and pN were significantly correlated with PFS by univariate analysis (p < 0.05). Multivariate analysis demonstrated that LNR was an independent prognostic factor for PFS (p < 0.01). Multivariate analysis also revealed that postoperative tumor staging (pT) classification (p = 0.003), LNR (p = 0.029), and surgical margins (p = 0.001) were independent prognostic factors for OS. LNR was demonstrated as an independent prognostic factor for PFS, other than LODDS and pN.
LNR was an independent predictor for OS and PFS for advanced HPSCC.
淋巴结比率（LNR）、阳性淋巴结对数比值（LODDS）以及术后淋巴结分期数量（pN）是多种癌症的预后指标。然而，这些指标在下咽鳞状细胞癌（HPSCC）中的预后价值仍不明确。本研究的主要目的是探讨LNR、LODDS和pN对晚期HPSCC的预测价值，次要目的是比较这些指标中哪一个对晚期HPSCC具有最佳预测价值。
对166例Ⅲ - Ⅳ期HPSCC患者进行回顾性研究。根据定义的临界值将LNR和LODDS分为两组。分别对总生存期（OS）和无进展生存期（PFS）风险进行单因素和多因素分析。使用受试者工作特征（ROC）曲线比较LNR与LODDS和pN的预测价值。
根据X-tile软件，LNR的临界值为0.11，LODDS的临界值为 - 0.91。单因素分析显示LNR、LODDS和pN与PFS显著相关（p < 0.05）。多因素分析表明LNR是PFS的独立预后因素（p < 0.01）。多因素分析还显示，术后肿瘤分期（pT）分类（p = 0.003）、LNR（p = 0.029）和手术切缘（p = 0.001）是OS的独立预后因素。LNR被证明是PFS的独立预后因素，而非LODDS和pN。
LNR是晚期HPSCC患者OS和PFS的独立预测指标。
