Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma
El-beshbeshi, W., Zaid, A., Eldamshety, O., Metwally, I., Eladl, E., Aboelnaga, E. (2020). Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma. EKB Journal Management System, 16(1), 22-30. doi: 10.21608/resoncol.2020.25204.1092
Wafaa El-beshbeshi; Amir M. Zaid; Osama Eldamshety; Islam H. Metwally; Entsar Eladl; Engy M. Aboelnaga. "Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma". EKB Journal Management System, 16, 1, 2020, 22-30. doi: 10.21608/resoncol.2020.25204.1092
El-beshbeshi, W., Zaid, A., Eldamshety, O., Metwally, I., Eladl, E., Aboelnaga, E. (2020). 'Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma', EKB Journal Management System, 16(1), pp. 22-30. doi: 10.21608/resoncol.2020.25204.1092
El-beshbeshi, W., Zaid, A., Eldamshety, O., Metwally, I., Eladl, E., Aboelnaga, E. Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma. EKB Journal Management System, 2020; 16(1): 22-30. doi: 10.21608/resoncol.2020.25204.1092

Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma

Research in Oncology
Article 5, Volume 16, Issue 1, June 2020, Page 22-30  XML PDF (363.23 K)
Document Type: Original Article
DOI: 10.21608/resoncol.2020.25204.1092
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Authors
Wafaa El-beshbeshi1; Amir M. Zaid2; Osama Eldamshety2; Islam H. Metwally2; Entsar Eladl3; Engy M. Aboelnaga email orcid 1
1Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2Department of Surgical Oncology, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
3Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Abstract
Background: Lymph node ratio (LNR) is the number of positive lymph nodes (LNs) divided by the total number of excised nodes. It has been shown to be of prognostic significance in a number of cancers.
Aim: To investigate the relation between LNR and survival of patients with head and neck squamous cell carcinoma (HNSCC).
Methods: A retrospective study of 115 patients with HNSCC treated with curative surgery including neck dissection ± adjuvant treatment from January 2013 to December 2017.
Results: The median LNR among node-positive patients was 0.14 which was used as a cutoff point to divide patients into two risk groups. Male gender, N2 stage, high grade and extranodal extension were significantly associated with high (≥0.14) LNR. In multivariate analysis, high LNR, higher TNM nodal stage and larger absolute number of positive LNs associated significantly with worse overall and disease-free survival. In a subgroup analysis of node-positive cases (n=54), LNR associated significantly with disease-free survival but not overall survival.  On the other hand, the absolute number of positive LNs and N stage had a significant effect on both overall and disease-free survival.
Conclusion: The LNR is of prognostic significance for survival and disease failure in HNSCC. This is also true for the absolute number of positive LNs. Standardization of LN status assessment and determination of an agreed upon cutoff value for LNR are needed before considering its incorporation in the staging system and treatment strategy.
Keywords
Head and neck; Lymph node ratio; Lymph node stage; Prognosis; Squamous cell carcinoma
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