Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival
Abdulkadir Imre1, Ercan Pinar2, Elif Dincer2
1Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey kadir_imre@yahoo.com.
Objective:
We investigated the value of lymph node density (LND) as a predictor of survival in patients with laryngeal squamous cell carcinoma (SCC) and positive neck node (pN+) after laryngectomy.
Study Design:
Case series with chart review.
Setting:
Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
Subjects And Methods:
We reviewed the records of 289 patients with newly diagnosed primary laryngeal carcinomas who underwent partial or total laryngectomy and combined neck dissection at a tertiary referral center between June 2006 and December 2014. Patients with pN+ laryngeal SCC (n = 101) were included in the study. Overall survival (OS) and disease-free survival (DFS) were used to evaluate the prognostic significance of LND.
Results:
In 101 patients with pN+ laryngeal SCC, LND ≥0.09 and number of metastatic lymph nodes >4 were significantly associated with OS and DFS but not the overall tumor, node, and metastasis stage. Forward stepwise Cox regression analysis revealed that LND ≥0.09 was the only independent predictor of both DFS and OS. Furthermore, the odds ratio of LND ≥0.09 was 10 times higher in patients with regional recurrence when compared patients without regional recurrence.
Conclusions:
LND was the only independent prognostic predictor of OS and DFS in patients with pN+ laryngeal SCC. Moreover, patients with LND ≥0.09 were significantly associated with high risk of regional recurrence. Thus, patients with LND ≥0.09 are at high risk of regional recurrence and death and may be considered for adjuvant chemoradiation.
