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.
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。