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Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma

OBJECTIVES: Lymph node metastasis in oral squamous cell carcinoma (OSCC) is a poor prognostic factor. The histopathologic stage (e.g., pN) is used to evaluate the severity of lymph node metastasis; however, the current staging system insufficiently predicts survival and recurrence. We investigated c...

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Autores principales: Chang, Wei-Chin, Lin, Chun-Shu, Yang, Cheng-Yu, Lin, Chih-Kung, Chen, Yuan-Wu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866838/
https://www.ncbi.nlm.nih.gov/pubmed/29038963
http://dx.doi.org/10.1007/s00784-017-2247-3
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author Chang, Wei-Chin
Lin, Chun-Shu
Yang, Cheng-Yu
Lin, Chih-Kung
Chen, Yuan-Wu
author_facet Chang, Wei-Chin
Lin, Chun-Shu
Yang, Cheng-Yu
Lin, Chih-Kung
Chen, Yuan-Wu
author_sort Chang, Wei-Chin
collection PubMed
description OBJECTIVES: Lymph node metastasis in oral squamous cell carcinoma (OSCC) is a poor prognostic factor. The histopathologic stage (e.g., pN) is used to evaluate the severity of lymph node metastasis; however, the current staging system insufficiently predicts survival and recurrence. We investigated clinical outcomes and lymph node density (LND) in betel nut-chewing individuals. MATERIAL AND METHODS: We retrospectively analyzed 389 betel nut-exposed patients with primary OSCC who underwent surgical resection in 2002–2015. The prognostic significance of LND was evaluated by overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. RESULTS: Kaplan-Meier analyses showed that the 5-year OS and DFS rates in all patients were 60.9 and 48.9%, respectively. Multivariate analysis showed that variables independently prognostic for OS were aged population (hazard ratio [HR] = 1.6, 95% confidence interval [95% CI] = 1.1–2.5; P = .025), and cell differentiation classification (HR = 2.4, 95% CI = 1.4–4.2; P = .002). In pathologic N-positive patients, a receiver operating characteristic (ROC) curve for OS was used and indicated the best cutoff of 0.05, and the multivariate analysis showed that LND was an independent predictor of OS (HR = 2.2, 95% CI = 1.3–3.7; P = .004). CONCLUSIONS: Lymph node density, at a cutoff of 0.05, was an independent predictor of OS and DFS. OS and DFS underwent multiple analyses, and LND remained significant. The pathologic N stage had no influence in the OS analysis. CLINICAL RELEVANCE: LND is a more reliable predictor of survival in betel nut-chewing patients for further post operation adjuvant treatment, such as reoperation or adjuvant radiotherapy.
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spelling pubmed-58668382018-03-27 Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma Chang, Wei-Chin Lin, Chun-Shu Yang, Cheng-Yu Lin, Chih-Kung Chen, Yuan-Wu Clin Oral Investig Original Article OBJECTIVES: Lymph node metastasis in oral squamous cell carcinoma (OSCC) is a poor prognostic factor. The histopathologic stage (e.g., pN) is used to evaluate the severity of lymph node metastasis; however, the current staging system insufficiently predicts survival and recurrence. We investigated clinical outcomes and lymph node density (LND) in betel nut-chewing individuals. MATERIAL AND METHODS: We retrospectively analyzed 389 betel nut-exposed patients with primary OSCC who underwent surgical resection in 2002–2015. The prognostic significance of LND was evaluated by overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. RESULTS: Kaplan-Meier analyses showed that the 5-year OS and DFS rates in all patients were 60.9 and 48.9%, respectively. Multivariate analysis showed that variables independently prognostic for OS were aged population (hazard ratio [HR] = 1.6, 95% confidence interval [95% CI] = 1.1–2.5; P = .025), and cell differentiation classification (HR = 2.4, 95% CI = 1.4–4.2; P = .002). In pathologic N-positive patients, a receiver operating characteristic (ROC) curve for OS was used and indicated the best cutoff of 0.05, and the multivariate analysis showed that LND was an independent predictor of OS (HR = 2.2, 95% CI = 1.3–3.7; P = .004). CONCLUSIONS: Lymph node density, at a cutoff of 0.05, was an independent predictor of OS and DFS. OS and DFS underwent multiple analyses, and LND remained significant. The pathologic N stage had no influence in the OS analysis. CLINICAL RELEVANCE: LND is a more reliable predictor of survival in betel nut-chewing patients for further post operation adjuvant treatment, such as reoperation or adjuvant radiotherapy. Springer Berlin Heidelberg 2017-10-17 2018 /pmc/articles/PMC5866838/ /pubmed/29038963 http://dx.doi.org/10.1007/s00784-017-2247-3 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Chang, Wei-Chin
Lin, Chun-Shu
Yang, Cheng-Yu
Lin, Chih-Kung
Chen, Yuan-Wu
Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
title Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
title_full Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
title_fullStr Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
title_full_unstemmed Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
title_short Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
title_sort lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866838/
https://www.ncbi.nlm.nih.gov/pubmed/29038963
http://dx.doi.org/10.1007/s00784-017-2247-3
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