Comparison of the prognostic value of lymph node yield, lymph node ratio, and number of lymph node metastases in...

Area of Science:

• Oncology
• Surgical Pathology
• Cancer Prognostics

Background:

• Oral squamous cell carcinoma (OSCC) is a significant global health concern.
• Accurate prognostic markers are crucial for effective patient management in OSCC.

Purpose of the Study:

• To evaluate the prognostic significance of lymph node yield (LNY), lymph node ratio (LNR), and the number of lymph node metastases (LNMs) in OSCC patients.
• To determine optimal thresholds for these parameters to predict patient outcomes.

Main Methods:

• Retrospective analysis of 429 OSCC patients who underwent surgical treatment.
• Determination of optimal prognostic thresholds using Receiver Operating Characteristic (ROC) curves.
• Survival analysis using Kaplan-Meier curves and log-rank tests.
• Model fit comparison using Akaike's Information Criterion (AIC).

Main Results:

• Optimal thresholds identified: LNY at 22, LNR at 6.6%, and LNMs at 3.
• Significant improvement in overall and progression-free survival observed for patients with LNR ≤6.6% or LNMs ≤3 (p<0.05).
• LNY did not show prognostic significance.
• AIC analysis indicated LNMs as a superior prognostic indicator over LNY and LNR.

Conclusions:

• LNR and the number of LNMs hold prognostic value in OSCC.
• Incorporating LNR or LNMs into the TNM staging system could enhance prognostic accuracy for OSCC.
• The number of LNMs is a strong candidate for inclusion in future N staging criteria for OSCC.