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Number of positive lymph nodes combined with the logarithmic ratio of positive lymph nodes predicts long-term survival for patients with node-positive parotid gland carcinoma after surgery: a SEER population-based study

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Abstract

Purpose

To evaluate the prognostic value of the number of positive lymph nodes (NPLN), the ratio of positive lymph nodes (pLNR), and the logarithmic ratio of positive lymph nodes (LODDS) in patients with parotid gland carcinoma. On this basis, establishing and validating an optimal nomogram.

Methods

A total of 895 patients with T1-4N1-3M0 parotid gland carcinoma were included in our study from the Surveillance, Epidemiology, and End Results (SEER) database. Patients’ data were randomly assigned to the training cohort and the validation cohort by a ratio of 7:3. Univariate and multivariate COX regression analysis were used to explore the relationship between the study factors and the prognosis of parotid gland carcinoma, including overall survival (OS) and cause-specific survival (CSS). The Akaike Information Criterion (AIC) was used to evaluate model fit. Harrell's concordance index (C-index), integrated discrimination improvement (IDI), and net reclassification index (NRI) were used to evaluate the predictive ability of these models. The decision curve analysis was used to evaluate the clinical benefit of the nomograms compared with the TNM stage.

Results

NPLN, pLNR, and LODDS are independent risk factors for the prognostic of PGC. According to the AIC, C index, IDI, and NRI, the models combined with NPLN and LODDS were the best. The decision curves suggested that our nomograms had good predictive abilities for the prognosis of parotid gland carcinoma.

Conclusion

The two nomograms which contained NPLN and LODDS had the potential to predict OS and CSS in patients with parotid gland carcinoma.

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Data availability

The data that support the findings of this study are available from SEER database but restrictions apply to the availability of these data, which were used under license for the current study (ID:12111-Nov2021), and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of SEER database.

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Funding

1. Special Finance Project of Fujian Province [Grant numbers: 2019B022]. 2. Leading project of Fujian Science and Technology Department [Grant numbers: 2021Y0016]. 3.Innovation Joint Fund of Fujian Science and Technology Department [Grant numbers: 2020Y9085].

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Author notes

  1. Xiaoxia Lin and Qin Lin contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fuzhou, 350001, Fujian, China

    Xiaoxia Lin, Qin Lin, Xiaoqiang Chen & Desheng Wang

Authors
  1. Xiaoxia Lin
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  2. Qin Lin
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  3. Xiaoqiang Chen
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  4. Desheng Wang
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Corresponding author

Correspondence to Desheng Wang.

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Conflict of interest

The authors declare no conflicts of interest in the work.

Ethical approval

Ethics approval or patient written informed consent were not required because all analyses in our study were performed based on data from the public databases (the SEER database, PubMed, EMBASE, and Cochrane databases).

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Lin, X., Lin, Q., Chen, X. et al. Number of positive lymph nodes combined with the logarithmic ratio of positive lymph nodes predicts long-term survival for patients with node-positive parotid gland carcinoma after surgery: a SEER population-based study. Eur Arch Otorhinolaryngol 280, 2541–2550 (2023). https://doi.org/10.1007/s00405-023-07848-7

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