Impact of lymph node ratio and number of lymph node metastases on survival and recurrence in laryngeal squamous cell carcinoma

Author:

Molteni Gabriele12ORCID,Nocini Riccardo2,Mattioli Francesco3,Nakayama Meijin4,Dedivitis Rogerio A.5ORCID,Mannelli Giuditta6ORCID,Crosetti Erika7ORCID,Chiesa‐Estomba Carlos Miguel8ORCID,Sistiaga‐Suarez Jon A.9,Giordano Leone10ORCID,Galli Andrea10,Lionello Marco11,Mercante Giuseppe1213ORCID,Ralli Massimo14ORCID,Fermi Matteo1516ORCID,Klein‐Rodríguez Alejandro17,Mayo‐Yáñez Miguel17ORCID,Serafini Edoardo3,Pirola Francesca1213ORCID,Paderno Alberto18,Cambria Francesca14,Oridate Nobuhiko19,Sano Daisuke19ORCID,Boscolo‐Rizzo Paolo20,Marcuzzo Alberto Vito20ORCID,Parrinello Giampiero21,Marchi Filippo2122ORCID,Saibene Alberto Maria23ORCID,Tucciarone Manuel24,Viscasillas Guillem25,Zeleník Karol26,Ramos Daniel Marin27,Palacios‐Garcia Jose28,Tirelli Giancarlo20,Pellini Raul29,Paludetti Gaetano3031,Galli Jacopo3031,Rossi Giorgia3031,De Vincentiis Marco14,Cernea Claudio Roberto32ORCID,Spriano Giuseppe1213,Bussi Mario10,Peretti Giorgio2122,Succo Giovanni33ORCID,Piazza Cesare18ORCID,Bertolin Andy11,Kowalski Luiz Paulo32,Presutti Livio1516,Sacchetto Andrea2ORCID

Affiliation:

1. Department of Otolaryngology – Head and Neck Surgery University Hospital of Verona Verona Italy

2. Unit of Otolaryngology, Department of Surgery, Dentistry and Pediatrics University of Verona Verona Italy

3. Department of Otorhinolaryngology – Head and Neck Surgery University Hospital of Modena Modena Italy

4. Department of Otolaryngology Yokosuka Kyosai Hospital Yokohama Japan

5. Department of Head and Neck Surgery University of Sao Paulo School of Medicine Sao Paulo Brazil

6. Department of Experimental and Clinical Medicine University of Florence Florence Italy

7. Department of Otorhinolaryngology San Luigi Gonzaga Hospital, University of Turin Turin Italy

8. Department of Otorhinolaryngology – Head and Neck Surgery, Donostia University Hospital, Biodonostia Research Institute Faculty of Medicine, Deusto University San Sebastian Spain

9. Department of Otorhinolaryngology – Head and Neck Surgery Donostia University Hospital San Sebastian Spain

10. Department of Otolaryngology – Head and Neck Surgery San Raffaele Scientific Institute, Vita‐Salute University Milan Italy

11. Unit of Otorhinolaryngology Vittorio Veneto Hospital Vittorio Veneto Italy

12. Unit of Otorhinolaryngology IRCCS Humanitas Research Hospital Milan Italy

13. Department of Biomedical Sciences Humanitas University Milan Italy

14. Department of Sense Organs Sapienza University of Rome Rome Italy

15. Department of Otorhinolaryngology – Head and Neck Surgery IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna Italy

16. Department of Specialist, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum Università di Bologna Bologna Italy

17. Department of Otorhinolaryngology – Head and Neck Surgery Complexo Hospitalario Universitario A Coruña A Coruña Spain

18. Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy

19. Department of Otolaryngology – Head and Neck Surgery Yokohama City University School of Medicine Yokohama Japan

20. Section of Otolaryngology, Department of Medical, Surgical and Health Sciences University of Trieste Trieste Italy

21. Department of Otorhinolaryngology – Head and Neck Surgery IRCCS Ospedale Policlinico San Martino Genoa Italy

22. Department of Surgical Sciences and Integrated Diagnostics (DISC) University of Genoa Genoa Italy

23. Unit of Otolaryngology, Santi Paolo e Carlo Hospital, Department of Health Sciences Università degli Studi di Milano Milan Italy

24. Department of Otorhinolaryngology University Hospital of Jerez Cádiz Spain

25. Department of Otolaryngology – Head and Neck Althaia, Xarxa Assitencial Universitaria de Manresa Barcelona Spain

26. Department of Otorhinolaryngology – Head and Neck Surgery University Hospital Ostrava Ostrava Czech Republic

27. Department of Head and Neck Surgery Cancer Institute of São Paulo ICESP São Paulo Brazil

28. Department of Otorhinolaryngology – Head and Neck Surgery Hospital Universitario Virgen Macarena Seville Spain

29. Department of Otolaryngology – Head and Neck Surgery IRCCS Regina Elena National Cancer Institute Rome Italy

30. Unit of Otorhinolaryngology Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy

31. Department of Head and Neck and Sensory Organs Università Cattolica del Sacro Cuore Rome Italy

32. Department of Head and Neck Surgery University of São Paulo Medical School São Paulo Brazil

33. Unit of Otolaryngology – Head and Neck Surgery San Giovanni Bosco Hospital Turin Italy

Abstract

AbstractIntroductionThe aim of this study is to assess the impact of lymph node ratio (LNR) and number of positive lymph nodes (NPLN) on mortality and recurrence rates in patients with laryngeal squamous cell carcinoma.Materials and methodsWe conducted a retrospective multicenter international study involving 24 Otorhinolaryngology‐Head and Neck Surgery divisions. Disease‐specific survival (DSS) and disease‐free survival (DFS) were evaluated as the main outcomes. The curves for DSS and DFS according to NPLN and LNR were analyzed to identify significant variations and establish specific cut‐off values.Results2507 patients met the inclusion criteria. DSS and DFS were significantly different in the groups of patients stratified according to LNR and NPLN. The 5‐year DSS and DFS based on LNR and NPLN demonstrated an improved ability to stratify patients when compared to pN staging.ConclusionOur data demonstrate the potential prognostic value of NPLN and LNR in laryngeal squamous cell carcinoma.

Publisher

Wiley

Subject

Otorhinolaryngology

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