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Development and internal validation of risk stratification tool for lymph node metastasis in pT3-4 laryngeal squamous
Changding He1, Yu Heng1, Xiaoke Zhu1
1Fudan University, Department of Otorhinolaryngology, Eye and ENT Hospital, Shanghai, China.
Objective:
To identify risk factors for Lymph Node Metastasis (LNM) in pT3-4 Laryngeal Squamous Cell Carcinoma (LSCC) patients with negative margins, and develop a nomogram to predict LNM risk.
Methods:
872 patients were divided into training (2010-2014) and validation (2015-2016) cohorts. Univariate and multivariate analyses identified LNM risk factors. A nomogram incorporating significant factors was developed in the training cohort.
Results:
Smoking history, maximal tumor diameter ≥3.0 cm, depth of tumor invasion >1.0 cm, and supraglottic tumor location were significantly associated with LNM on multivariate analysis. A predictive nomogram incorporating these factors showed good discrimination (C-index > 0.7) in both cohorts. Patients were stratified into low, moderate and high-risk subgroups based on total risk scores.
Conclusions:
A LNM risk prediction model and risk grouping system was established, which may aid treatment selection for pT3-4 LSCC patients. The model and algorithm could help optimize neck management for this high-risk patient population.
