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Risk factors and prognostic models of lymph node metastatic hypopharyngeal squamous cell carcinoma

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To explore the risk factors for lymph node metastasis (LNM) and establish nomograms for predicting survival outcomes and assessing individual risk in patients with LNM and hypopharyngeal squamous carcinoma (HSCC).

Methods

Clinical data of patients with HSCC were retrospectively reviewed. The study's primary endpoints were overall survival (OS) and disease-specific survival (DSS). Nomograms were established based on Cox regression analyses. The accuracy and calibration ability of the nomograms were evaluated using the C-index, area under the curve, calibration curves, and decision curve analysis.

Results

Overall, 2888 patients were enrolled, and the LNM rate was 74.2%. Age ≤ 60 years, male sex, unmarried status, pyriform sinus location, grade III–IV, tumor larger than 4 cm, and advanced T stage increased the risk of LNM. In addition, LNM was a negative prognostic factor for OS and DSS. Ten variables were identified and incorporated into nomograms to estimate OS and DSS. Our nomograms outperformed the traditional staging system in training and validation cohorts. Patients were stratified into risk subgroups based on the OS- and DSS-nomogram scores. Patients in the high-risk subgroup had a higher risk of death and disease-specific mortality than those in the low- and intermediate-risk subgroups.

Conclusions

LNM worsens the prognosis of HSCC. This study identified the independent prognostic factors for HSCC with LNM and developed satisfactory OS- and DSS-monogram to provide individual prediction and risk classification for patients with this diagnosis.

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Data availability

All data can be retrieved from publicly available SEER database. These data can be found here: https://seer.cancer.gov.

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Acknowledgements

The authors acknowledge the efforts of the SEER Program tumor registries in the creation of the SEER database and thank all the patients analyzed in this study.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Pan jia yuan nan Road 17, Beijing, 100021, China

    Di Zhang & Lixi Li

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  1. Di Zhang
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  2. Lixi Li
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Contributions

DZ and LL conceived and designed the study. DZ analyzed data and wrote the paper, and LL make suggestion and revised the paper. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Lixi Li.

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Zhang, D., Li, L. Risk factors and prognostic models of lymph node metastatic hypopharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 280, 5019–5029 (2023). https://doi.org/10.1007/s00405-023-08077-8

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