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Which is the most suitable lymph node predictor for overall survival after primary surgery of head and neck cancer: pN, the number or the ratio of positive lymph nodes, or log odds?

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

To investigate the best lymph node (LN) metastasis predictor for overall survival (OS) in head neck cancer (HNC): pN classification, number of positive lymph nodes (PNOD), lymph node ratio (LNR), or log odds of positive lymph nodes (LODDS).

Methods

In total, 225 surgically treated HNC patients were evaluated for the different LN classifications and OS.

Results

Five-year OS was 71.8 %. Mean number of yielded LN and PNOD was 25.3 ± 16.7 and 2.7 ± 5.9, respectively. 64.8 % had a LNR > 0.10 and 64.4 % a LODDS > 10. In univariable analysis, multimodal therapy (p = 0.039), advanced pT (p < 0.0001), advanced UICC stage (p = 0.029), LNR > 0.10 (p = 0.049), and LODDS > −1.0 (p = 0.021) were associated with lower OS. In multivariable analysis, advanced pT [hazard ratio (HR) 2.194; 95 % confidence interval (CI) 1.294–3.722; p = 0.004] and LODDS > −1.0 (HR 1.634; 95 % CI 1.002–2.665; p = 0.059) remained independent predictors for lower OS.

Conclusions

It seems useful to analyze the prognostic significance of LODDS in other samples of HNC.

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Acknowledgments

We like to thank all outpatient clinics that were involved in the treatment and data collection of the patients for the cancer registry. We thank the coordinator of the Jena cancer registry, Mrs. Ulrike Burger, for her collaboration.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany

    Mehmet Metin Yildiz & Orlando Guntinas-Lichius

  2. Institute of Pathology, Jena University Hospital, Jena, Germany

    Iver Petersen

  3. University Tumor Center, Jena University Hospital, Jena, Germany

    Ekkehard Eigendorff

  4. Department of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany

    Peter Schlattmann

Authors
  1. Mehmet Metin Yildiz
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  2. Iver Petersen
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  5. Orlando Guntinas-Lichius
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Correspondence to Orlando Guntinas-Lichius.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Yildiz, M.M., Petersen, I., Eigendorff, E. et al. Which is the most suitable lymph node predictor for overall survival after primary surgery of head and neck cancer: pN, the number or the ratio of positive lymph nodes, or log odds?. J Cancer Res Clin Oncol 142, 885–893 (2016). https://doi.org/10.1007/s00432-015-2104-1

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  • DOI: https://doi.org/10.1007/s00432-015-2104-1

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