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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2017
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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. |
format | Online Article Text |
id | pubmed-5866838 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
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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