Lymph node density is a significant predictor of outcome in patients with oral cancer

We investigated whether an lymph node density model can be used to predict patient outcome

Ziv Gil; Diane L. Carlson; Jay O. Boyle; Dennis H. Kraus; Jatin P. Shah; Ashok R. Shaha; Bhuvanesh Singh; Richard J. Wong; Snehal G. Patel

2009

Scholarcy highlights

  • The impact of lymph node metastases on prognosis in patients with oral cavity squamous cell carcinoma has been well recognized
  • The management of OSCC is largely surgical and adjuvant treatment including radiotherapy or chemoradiation is used for patients with advanced stage tumors
  • Because adjuvant therapy may induce severe toxic effects, a significant challenge is to find a reliable method for stratifying patients for the risk of tumor recurrence immediately after surgery
  • The presence of 1 or more positive lymph nodes is a significant predictor of poor outcome
  • We have evaluated for the first time, to our knowledge, the value of lymph node density in comparison with the conventional staging system to determine its ability to predict overall survival, disease-specific survival, and locoregional recurrence-free survival in patients undergoing neck dissection
  • We found no significant correlation between the total number of excised lymph nodes and the number of positive lymph node in the specimen
  • The data from the current study indicate that LND may be useful as an adjunct to the conventional staging system in clinical studies investigating the role of adjuvant therapy after surgery for patients with OSCC
  • Modern studies using multivariate analysis report that, among patients with positive neck metastases, lymph node stage does not necessarily predict prognosis, especially after adjuvant radiotherapy

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