Impact of lymph node ratio and number of lymph node metastases on survival and recurrence in laryngeal squamous cell carcinoma
Gabriele Molteni, Riccardo Nocini, Francesco Mattioli, Meijin Nakayama, Rogério Aparecido Dedivitis, Giuditta Mannelli, Erika Crosetti, Carlos M. Chiesa‐Estomba, Jon Alexander Sistiaga-Suárez, Leone Giordano, Andrea Galli, Marco Lionello, Giuseppe Mercante, Massimo Ralli, Matteo Fermi, Alejandro Klein‐Rodríguez, Miguel Mayo‐Yáñez, Edoardo Serafini, Francesca Pirola, Alberto Paderno, Francesca Cambria, Nobuhiko Oridate, Daisuke Sano, Paolo Boscolo‐Rizzo, Alberto Vito Marcuzzo, Giampiero Parrinello, Filippo Marchi, Alberto Maria Saibene, Manuel Tucciarone, Guillem Viscasillas, Karol Zeleník, Daniel M. Ramos, José María Palacios-García, Giancarlo Tirelli, Raul Pellini, Gaetano Paludetti, Jacopo Galli, Giorgia Rossi, Marco de Vincentiis, Cláudio Roberto Cernea, Giuseppe Spriano, Mario Bussi, Giorgio Peretti, Giovanni Succo, Cesare Piazza, Andy Bertolin, Luiz Paulo Kowalski, Livio Presutti, Andrea Sacchetto
Abstract
INTRODUCTION: The aim of this study is to assess the impact of lymph node ratio (LNR) and number of positive lymph nodes (NPLN) on mortality and recurrence rates in patients with laryngeal squamous cell carcinoma. MATERIALS AND METHODS: We conducted a retrospective multicenter international study involving 24 Otorhinolaryngology-Head and Neck Surgery divisions. Disease-specific survival (DSS) and disease-free survival (DFS) were evaluated as the main outcomes. The curves for DSS and DFS according to NPLN and LNR were analyzed to identify significant variations and establish specific cut-off values. RESULTS: 2507 patients met the inclusion criteria. DSS and DFS were significantly different in the groups of patients stratified according to LNR and NPLN. The 5-year DSS and DFS based on LNR and NPLN demonstrated an improved ability to stratify patients when compared to pN staging. CONCLUSION: Our data demonstrate the potential prognostic value of NPLN and LNR in laryngeal squamous cell carcinoma.