Significance of examined lymph nodes number and metastatic lymph nodes ratio in overall survival and adjuvant treatment decision in resected laryngeal carcinoma

Zhu, Xiaoke; Zhao, Min; Zhou, Liang; Zhang, Ming; Cao, Pengyu; Tao, Lei

doi:10.1002/cam4.2902

Cited by 21 publications

(20 citation statements)

References 18 publications

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“…In concordance with our results, a recent retrospective SEER (surveillance, epidemiology, and end results program, National Cancer Institute) database analysis considered an apparently bilateral nodal yield cut-off of n > 50 as an independent prognosticator for overall survival (HR: 0.794, p = 0.006) using a dataset of partial laryngectomy and TL patients (Zhu et al 2020 ). The lack of a statistically significant NY cut-off at n = 50 in our work might be attributable to the low sample size of n = 37.…”

Section: Discussionsupporting

confidence: 88%

“…This might be due to the earlier timespan (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014), the lower mean nodal count of n = 18.7 (not reaching the current mean/ipsilateral count of n = 26.9), and the lack of sufficient adjuvant treatment protocols. The estimated 5-year OS rates of 60% (from date of first diagnosis) and 57% (from date of TL) for the entire cohort are notably higher than stated in other earlier studies [51.1% (Zhu et al 2020), 48% (Sullivan et al 2019), 40% (McGuire et al 2019, and 32.1% (Böttcher et al 2016)], which was not solely attributable to NY count.…”

Section: Discussioncontrasting

confidence: 53%

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Rational surgical neck management in total laryngectomy for advanced stage laryngeal squamous cell carcinomas

Böttcher

Betz

Bartels

et al. 2020

J Cancer Res Clin Oncol

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Purpose Controversies exist in regard to surgical neck management in total laryngectomies (TL). International guidelines do not sufficiently discriminate neck sides and sublevels, or minimal neck-dissection nodal yield (NY). Methods Thirty-seven consecutive primary TL cases from 2009 to 2019 were retrospectively analyzed in terms of local tumor growth using a previously established imaging scheme, metastatic neck involvement, and NY impact on survival. Results There was no case of level IIB involvement on any side. For type A and B tumor midline involvement, no positive contralateral lymph nodes were found. Craniocaudal tumor extension correlated with contralateral neck involvement (OR: 1.098, p = 0.0493) and showed increased involvement when extending 33 mm (p = 0.0134). Using a bilateral NY of ≥ 24 for 5-year overall survival (OS) and ≥ 26 for 5-year disease-free survival (DFS) gave significantly increased rate advantages of 64 and 56%, respectively (both p < 0.0001). Conclusions This work sheds light on regional metastatic distribution pattern and its influence on TL cases. An NY of n ≥ 26 can be considered a desirable benchmark for bilateral selective neck dissections as it leads to improved OS and DFS. Therefore, an omission of distinct neck levels cannot be promoted at this time.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 53%

Rational surgical neck management in total laryngectomy for advanced stage laryngeal squamous cell carcinomas

Böttcher

Betz

Bartels

et al. 2020

J Cancer Res Clin Oncol

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“…There are still several limitations in the present study which should be highlighted, including its retrospective nature and potential selection biases [20] . Furthermore, information about some potential prognostic factors, such as the detailed chemotherapy protocol, molecular or genomic data, were not available in this database.…”

Section: Discussionmentioning

confidence: 94%

A Nomogram with Lymph Node Status Predicts Survival and the Benefit of Postoperative Radiotherapy in IIIA-N2 Non-small Cell Lung Cancer Patients after Surgery

Chen

Dong

et al. 2020

Preprint

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Objective: This study aimed at establishing a novel nomogram predicting overall survival and investigating the survival benefit of postoperative radiotherapy in IIIA-N2 Non-small cell lung cancer (NSCLC) patients after surgery.Methods: Data of IIIA-N2 NSCLC patients between 2004 and 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER). Patients were excluded if the information regarding follow-up time and clinicopathological features were incomplete. Through Univariate and multivariate analyses, independent prognostic factors were identified and integrated into the construction of nomogram. The survival benefit of PORT was investigated in model-defined low-risk, intermediate-risk, and high-risk subgroups, respectively.Results: In total, 4389 patients were finally included for analysis. Patients’ age, sex, T stage, differentiation grade, examined lymph nodes number (ELN), metastatic lymph nodes number (MLN), and metastatic lymph nodes ratio (LNR) were identified as independent prognostic factors and were integrated into the construction of nomogram. The C-index and calibration curves indicated that the predictive performance of the nomogram was satisfactory. Patients were then categorized into three prognostic groups with the increasing risk of all-cause of death. Only patients in high-risk group could benefit from PORT.Conclusion: In this large-cohort retrospective study, A survival-predicting nomogram and risk stratification model were established to estimate prognosis in IIIA-N2 NSCLC patients. PORT was recommended for those patients in high-risk group. This study may provide additional integration, introspection, and improvement for therapeutic decision-making.

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“…The prognostic predicting significance of LNR on patients with laryngeal cancer calculated at baseline has been described recently 25 , 26 . This surrogate mathematical marker was also included in the nomogram recently proposed by Zhu et al and facilitates risk stratification for the decision of adjuvant treatment 27 . Nevertheless, the prognostic influence of LNR has not been validated in the long-term follow-up by time-dependent regression models.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma

Lin¹,

Lin²,

Chen³

et al. 2021

J. Cancer

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Purpose: To evaluate long-term survival trends after primary total laryngectomy (TL) for locally advanced laryngeal carcinoma (LC). Methods: A total of 2094 patients diagnosed with locally advanced LC and underwent primary TL (1992-2011, at least 5-year follow-up) in the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. Besides the traditional overall survival (OS) and cancer-specific survival (CSS) by using Kaplan-Meier curves, the 3-year conditional survival analysis was also performed to describe the long-term trends in these patients. Time-dependent multivariate competing-risk models were constructed to assess the persistent sub-distribution hazard of prognostic factors. Finally, a nomogram was developed to predict conditional cancer-specific survival. Results: The curves of overall hazard and cancer-specific hazard both quickly reached the apex within the first year since TL, then decreased thereafter. In general, the CS3 steadily increased from within 5 years after TL. In the stratified CS3 analysis, the increments in patients with adverse characteristics were more pronounced. 4 years after TL, the probability of surviving the next year exceeded 90%. The time-dependent multivariate competing-risk models indicated that age and lymph node ratio (LNR) persistently contributed to the cancer-specific outcome. The nomogram based on the competing-risk model was constructed to estimate CSS probability conditional upon 3 years for advanced LC patients having survived 1, 2, and 3 years. Conclusion: Most patients achieved a substantially improved survival rate after surviving a long period after primary TL. Patients diagnosed at older age and with higher LNR should receive more effective follow-up. The predictive nomogram can provide significant evidence for clinical research and practice.

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Significance of examined lymph nodes number and metastatic lymph nodes ratio in overall survival and adjuvant treatment decision in resected laryngeal carcinoma

Cited by 21 publications

References 18 publications

Rational surgical neck management in total laryngectomy for advanced stage laryngeal squamous cell carcinomas

Rational surgical neck management in total laryngectomy for advanced stage laryngeal squamous cell carcinomas

A Nomogram with Lymph Node Status Predicts Survival and the Benefit of Postoperative Radiotherapy in IIIA-N2 Non-small Cell Lung Cancer Patients after Surgery

Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma

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