Lymph node density as a predictive factor for worse outcomes in laryngeal cancer
Sílvia Petrarolha1, Rogério Dedivitis2, Leandro Matos2
1University of Sao Paulo School of Medicine, Head and Neck Surgery, Av. Conselheiro Nébias, 444, conj. 1605, Santos, SP, 11045-000, Brazil. silvia@picado.com.br.
Background:
The lymph node density (LND) is the number of positive metastatic lymph nodes divided by the total number of dissected lymph nodes. The purpose of this study was to evaluate LND as a prognostic factor in patients with laryngeal squamous cell carcinoma (SCC).
Methods:
The study included 186 patients with laryngeal SCC submitted to laryngeal surgical treatment with neck dissection between January 2009 and December 2016. Clinical-pathological variables were assessed, as well as the cut-off point for LND.
Results:
LND value was calculated considering pN+ (LND = 0.060). The Kaplan-Meier curve (log-rank) related to cumulative survival demonstrated that patients with LND ≥ 0.060 had a higher mortality rate than those with LND < 0.060, presenting a more aggressive form of the disease, with earlier recurrence. However, only the LND ≥ 0.060 group had impact on both disease-free survival and overall survival.
Conclusion:
The LND proved to be an important index in the prognostic evaluation of larynx SCC patients having a direct relationship with disease recurrence. Patients with LND ≥ 0.060 should be considered for adjuvant therapy.
