Prognostic Significance of Lymph Node Density in Patients with Hypopharyngeal Squamous Cell Carcinoma

Abstract

The median LND cutoff values ≥0.055 are associated with a greater risk of recurrence and survival in patients with HPSCC.

Impact of tumor dimensions and lymph node density on the survival of patients with hypopharyngeal squamous cell carcinoma

“…13 Nevertheless, some patients continue to face a dismal prognosis. 8 , 9 , 11 , 12 , 14 Over the past decade, more attention has been directed toward the risk factors of surgical specimens, in addition to tumor-node-metastasis (TNM) staging, that might influence clinical outcomes. 8 – 12 , 14 – 18 Generally, the size and extent of the local spread of the primary tumor and the extent of regional dissemination are chief determinants of the prognosis in this distinct entity.…”

“…N+ disease is generally claimed to be the most potent prognostic indicator of early regional relapse, distant metastasis, and inferior survival in patients with hypopharyngeal cancer. 2 , 5 , 6 , 8 , 11 , 12 , 14 N+ hypopharyngeal cancer is staged as III/IV according to the AJCC staging system and is well established as a major matter of concern, with at least a 25% reduction in OS. 5 The LND, incorporating the burden of regional nodal disease with the extent of nodal dissection, addresses the role of neck dissection as both a diagnostic and therapeutic procedure.…”

“…Approximately 70%–87% of tumors are in advanced stages (III/IV disease) at initial presentation. 4 , 5 , 7 – 12 Despite aggressive combined treatment modalities, the prognosis of hypopharyngeal cancer remains the worst among UADT cancers. 1 – 3 …”

“…13 Nevertheless, the outcomes remain compromised, with 5-year overall survival (OS) rates ranging from 41% to 55%. 8 , 9 , 11 , 12 , 14 …”

“…We have previously demonstrated that some pathological characteristics are important prognostic factors. 8 The lymph node density (LND) in hypopharyngeal cancer is believed to be of greater prognostic value than traditional nodal staging, 8 , 11 , 12 , 14 which is calculated as the number of metastatic lymph nodes (LNs) divided by the total number of resected LNs. Additionally, the depth of invasion (DOI) 15 – 17 and the primary tumor volume (PTV) 9 , 10 , 18 are found to provide prognostic information in hypopharyngeal cancer.…”