Evaluation of lymph node ratio and lymph node yield as prognosticators of locoregional recurrence in p16-associated oropharyngeal squamous cell carcinoma
Margaret Nurimba BA
Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorWilliam Hines BS
Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorUttam Sinha MD
Tina and Rick Caruso Department of Otolaryngology—Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorAnna Mathew MD
Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorNiels Kokot MD
Tina and Rick Caruso Department of Otolaryngology—Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorCorresponding Author
Mark Swanson MD
Tina and Rick Caruso Department of Otolaryngology—Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Correspondence
Mark Swanson, MD, 1540 Alcazar Street, Suite 204M, Los Angeles, CA 90033, USA.
Email: [email protected]
Search for more papers by this authorMargaret Nurimba BA
Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorWilliam Hines BS
Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorUttam Sinha MD
Tina and Rick Caruso Department of Otolaryngology—Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorAnna Mathew MD
Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorNiels Kokot MD
Tina and Rick Caruso Department of Otolaryngology—Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Search for more papers by this authorCorresponding Author
Mark Swanson MD
Tina and Rick Caruso Department of Otolaryngology—Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
Correspondence
Mark Swanson, MD, 1540 Alcazar Street, Suite 204M, Los Angeles, CA 90033, USA.
Email: [email protected]
Search for more papers by this authorPortions of this work have been presented at the American Head and Neck Meeting at the 2019 Combined Otolaryngology Spring Meeting in Austin, Texas.
Abstract
Background
The prognostic value of lymph node yield (LNY) and lymph node ratio (LNR), or the ratio of number of metastatic LNs to total number dissected, has not been well established in p16-associated oropharyngeal squamous cell carcinoma (OPSCC).
Methods
This retrospective cohort study evaluated locoregional disease-free survival (LRDFS) in 82 patients with p16+ OPSCC who underwent neck dissection at a single institution from 2009 to 2017. LNR and LNY cutoffs were estimated using time-dependent receiver operator characteristic (ROC) curves. Prognostic significance of these cutoffs was compared with Eighth Edition AJCC Nodal Staging.
Results
An increased LNR ≥ 0.129 was associated with worse 2-year LRDFS (66.9% vs 96.8%, P = .005). LNY was not significantly associated with LRDFS (P = .304). An LNR-based risk model was a better prognosticator than Eighth Edition AJCC Nodal Staging (Harrell's C, 0.9065 vs 0.7668).
Conclusions
LNR has good prognostic utility in predicting LRDFS in p16+ OPSCC, but further evaluation of this measure is warranted.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| hed26324-sup-0001-supinfo.docxWord 2007 document , 290.1 KB | Table S1 Results of a blinded pathology review of neck dissection specimens (n = 21). Table S2. Lymph node yield and lymph node ratio cutoff point estimation by time-specific ROC analysis. Table S3. Univariate Cox proportional hazards analysis of risk factors for locoregional recurrence Table S4. Cramer V association analysis between LNR cutoff and histopathological characteristics Figure S1. Time-dependent area under the curve comparing ability of eighth edition AJCC nodal staging to an LNR cutoff of 0.129 to predict locoregional recurrence. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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