PDF(Pubmed)
Abstract：
OBJECTIVE: Different parameters have been identified in patients with oral squamous cell carcinomas (OSCC) that have a serious impact on survival, including residual tumour and extracapsular spread. Moreover, other factors, including the lymph node ratio (LNR) and lymph node yield (LNY), have been suggested as prognostic markers.
METHODS: This retrospective study included patients diagnosed with OSCC and cervical lymph node metastases during the years 2010-2020. Patients\' records were evaluated regarding lymph node status, final therapy regime, tumour recurrence, time to death, tumour association with death, disease-free survival (DSF), and overall survival (OS).
RESULTS: In 242 patients with a mean age of 63.57 ± 11.24 years, treated either by selective neck dissection (SND; n = 70) or by modified radical neck dissection (MRND; n = 172), 5772 lymph nodes were detected. The LNR and LNY were identified as independent risk factors in OS and DFS. The optimal cut-off point for the LNY was ≥ 17 lymph nodes in the SND and ≥ 27 lymph nodes in the MRND group. The metastatic lymph node clearance (MLNC) was established as a score to relate the LNR and LNY to the extent of lymph node removal. Survival analysis showed statistically significant differences among score levels.
CONCLUSIONS: As information about the extent of nodal dissection is excluded from LNR and LNY, we propose the use of a new scoring system comprising individual cut-off values for LNY and LNR with regard to the extent of neck dissection.
CONCLUSIONS: MLNC might help to identify high-risk OSCC patients with metastatic lymph nodes.
METHODS: This retrospective study included patients diagnosed with OSCC and cervical lymph node metastases during the years 2010-2020. Patients\' records were evaluated regarding lymph node status, final therapy regime, tumour recurrence, time to death, tumour association with death, disease-free survival (DSF), and overall survival (OS).
RESULTS: In 242 patients with a mean age of 63.57 ± 11.24 years, treated either by selective neck dissection (SND; n = 70) or by modified radical neck dissection (MRND; n = 172), 5772 lymph nodes were detected. The LNR and LNY were identified as independent risk factors in OS and DFS. The optimal cut-off point for the LNY was ≥ 17 lymph nodes in the SND and ≥ 27 lymph nodes in the MRND group. The metastatic lymph node clearance (MLNC) was established as a score to relate the LNR and LNY to the extent of lymph node removal. Survival analysis showed statistically significant differences among score levels.
CONCLUSIONS: As information about the extent of nodal dissection is excluded from LNR and LNY, we propose the use of a new scoring system comprising individual cut-off values for LNY and LNR with regard to the extent of neck dissection.
CONCLUSIONS: MLNC might help to identify high-risk OSCC patients with metastatic lymph nodes.
摘要：
目的：在口腔鳞状细胞癌（OSCC）患者中发现了对生存有严重影响的不同参数，包括残留肿瘤和囊外扩散。此外，其他因素,包括淋巴结比率(LNR)和淋巴结产量(LNY)，已被建议作为预后标志物。
方法：这项回顾性研究包括2010-2020年期间诊断为OSCC和颈淋巴结转移的患者。评估患者的淋巴结状态记录，最终治疗方案，肿瘤复发，时间到死亡,肿瘤与死亡的关联，无病生存（DSF），总生存率（OS）。
结果：在242名平均年龄为63.57±11.24岁的患者中，通过选择性颈清扫术（SND；n=70）或通过改良的根治性颈清扫术（MRND；n=172）进行治疗，检测到5772个淋巴结。LNR和LNY是OS和DFS的独立危险因素。LNY的最佳截止点是SND中≥17个淋巴结，MRND组中≥27个淋巴结。建立转移性淋巴结清除(MLNC)作为将LNR和LNY与淋巴结清除程度相关联的评分。生存分析显示得分水平之间的差异具有统计学意义。
结论：由于LNR和LNY不包括有关淋巴结解剖程度的信息，我们建议使用一种新的评分系统,该评分系统包括LNY和LNR关于颈部夹层范围的各个截止值.
结论：MLNC可能有助于识别具有转移性淋巴结的高风险OSCC患者。
方法：这项回顾性研究包括2010-2020年期间诊断为OSCC和颈淋巴结转移的患者。评估患者的淋巴结状态记录，最终治疗方案，肿瘤复发，时间到死亡,肿瘤与死亡的关联，无病生存（DSF），总生存率（OS）。
结果：在242名平均年龄为63.57±11.24岁的患者中，通过选择性颈清扫术（SND；n=70）或通过改良的根治性颈清扫术（MRND；n=172）进行治疗，检测到5772个淋巴结。LNR和LNY是OS和DFS的独立危险因素。LNY的最佳截止点是SND中≥17个淋巴结，MRND组中≥27个淋巴结。建立转移性淋巴结清除(MLNC)作为将LNR和LNY与淋巴结清除程度相关联的评分。生存分析显示得分水平之间的差异具有统计学意义。
结论：由于LNR和LNY不包括有关淋巴结解剖程度的信息，我们建议使用一种新的评分系统,该评分系统包括LNY和LNR关于颈部夹层范围的各个截止值.
结论：MLNC可能有助于识别具有转移性淋巴结的高风险OSCC患者。
