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Is Lymph-node Ratio a Superior Predictor than Lymph Node Status for Recurrence-free and Overall Survival in Patients with Head and Neck Squamous Cell Carcinoma?

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

TNM status is questioned as an exact predictor of survival in different tumour entities. Recently, lymph node ratio (LNR) has been described as a predictor of survival in patients with HNSCC. The purpose of this study was to evaluate to which degree LNR could be used as a more accurate predictor than TNM staging?

Methods

A total of 291 patients, with a follow-up of at least 3 years, were analyzed using log-rank statistic, univariate and multivariate data analyzes, and p values, for prediction of lymph node ratio on overall and recurrence-free survival.

Results

Survival differed significantly if patients were stratified for LNR. Impact of LNR on survival was significantly different even in patients with extracapsular spread. Patients with pN0 had no survival benefit compared with patients with pN1 or higher with a LNR lower than 6 %.

Conclusions

LNR is a prognostic tool in patients with a lymph node status pN0–pN2b. LNR remained significant even in patients with extracapsular spread, contrary to TNM status. With LNR, stratification for high-risk patients (higher than 6 % LNR) can be evaluated easily. We would suggest using LNR in the clinical routine.

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Acknowledgement

There is no financial disclosure.

Conflict of interest

Authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of General Otorhinolaryngology, Head and Neck Surgery, University Hospital of Graz, Graz, Austria

    Sabine Reinisch MD & Martin Lanzer MD, DMD

  2. Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zürich, Zürich, Switzerland

    Astrid Kruse MD, DMD, Marius Bredell MD, DMD, Heinz-Theo Lübbers MD, DMD, Thomas Gander MD, DMD & Martin Lanzer MD, DMD

Authors
  1. Sabine Reinisch MD
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  2. Astrid Kruse MD, DMD
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  3. Marius Bredell MD, DMD
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  4. Heinz-Theo Lübbers MD, DMD
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  5. Thomas Gander MD, DMD
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  6. Martin Lanzer MD, DMD
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Corresponding author

Correspondence to Martin Lanzer MD, DMD.

Additional information

Conduction of Study

Patient data derived from patients treated at the University Hospital of Graz (1). The study was approved by the Institutional Ethics Committee (EK-Nr. 21-020 ex 09/10).

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Reinisch, S., Kruse, A., Bredell, M. et al. Is Lymph-node Ratio a Superior Predictor than Lymph Node Status for Recurrence-free and Overall Survival in Patients with Head and Neck Squamous Cell Carcinoma?. Ann Surg Oncol 21, 1912–1918 (2014). https://doi.org/10.1245/s10434-014-3634-5

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  • DOI: https://doi.org/10.1245/s10434-014-3634-5

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