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

Gabriele Molteni; Riccardo Nocini; Francesco Mattioli; Meijin Nakayama; Rogerio A Dedivitis; Giuditta Mannelli; Erika Crosetti; Carlos Miguel Chiesa-Estomba; Jon A Sistiaga-Suarez; Leone Giordano; Andrea Galli; Marco Lionello; Giuseppe Mercante; Massimo Ralli; Matteo Fermi; Alejandro Klein-Rodríguez; Miguel Mayo-Yáñez; Edoardo Serafini; Francesca Pirola; Alberto Paderno; Francesca Cambria; Nobuhiko Oridate; Daisuke Sano; Paolo Boscolo-Rizzo; Alberto Vito Marcuzzo; Giampiero Parrinello; Filippo Marchi; Alberto Maria Saibene; Manuel Tucciarone; Guillem Viscasillas; Karol Zeleník; Daniel Marin Ramos; Jose Palacios-Garcia; Giancarlo Tirelli; Raul Pellini; Gaetano Paludetti; Jacopo Galli; Giorgia Rossi; Marco De Vincentiis; Claudio Roberto Cernea; Giuseppe Spriano; Mario Bussi; Giorgio Peretti; Giovanni Succo; Cesare Piazza; Andy Bertolin; Luiz Paulo Kowalski; Livio Presutti; Andrea Sacchetto

doi:10.1002/hed.27471

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

Head Neck. 2023 Sep;45(9):2274-2293. doi: 10.1002/hed.27471. Epub 2023 Jul 27.

Authors

Gabriele Molteni^{1

2}, Riccardo Nocini², Francesco Mattioli³, Meijin Nakayama⁴, Rogerio A Dedivitis⁵, Giuditta Mannelli⁶, Erika Crosetti⁷, Carlos Miguel Chiesa-Estomba⁸, Jon A Sistiaga-Suarez⁹, Leone Giordano¹⁰, Andrea Galli¹⁰, Marco Lionello¹¹, Giuseppe Mercante^{12

13}, Massimo Ralli¹⁴, Matteo Fermi^{15

16}, Alejandro Klein-Rodríguez¹⁷, Miguel Mayo-Yáñez¹⁷, Edoardo Serafini³, Francesca Pirola^{12

13}, Alberto Paderno¹⁸, Francesca Cambria¹⁴, Nobuhiko Oridate¹⁹, Daisuke Sano¹⁹, Paolo Boscolo-Rizzo²⁰, Alberto Vito Marcuzzo²⁰, Giampiero Parrinello²¹, Filippo Marchi^{21

22}, Alberto Maria Saibene²³, Manuel Tucciarone²⁴, Guillem Viscasillas²⁵, Karol Zeleník²⁶, Daniel Marin Ramos²⁷, Jose Palacios-Garcia²⁸, Giancarlo Tirelli²⁰, Raul Pellini²⁹, Gaetano Paludetti^{30

31}, Jacopo Galli^{30

31}, Giorgia Rossi^{30

31}, Marco De Vincentiis¹⁴, Claudio Roberto Cernea³², Giuseppe Spriano^{12

13}, Mario Bussi¹⁰, Giorgio Peretti^{21

22}, Giovanni Succo³³, Cesare Piazza¹⁸, Andy Bertolin¹¹, Luiz Paulo Kowalski³², Livio Presutti^{15

16}, Andrea Sacchetto²

Affiliations

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.

PMID: 37496499
DOI: 10.1002/hed.27471

Abstract

Introduction: The 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 methods: We 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.

Results: 2507 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.

Conclusion: Our data demonstrate the potential prognostic value of NPLN and LNR in laryngeal squamous cell carcinoma.

Keywords: laryngeal cancer; lymph node; lymph node metastasis; lymph node ratio; oncology.

Publication types

Multicenter Study

MeSH terms

Head and Neck Neoplasms* / pathology
Humans
Lymph Node Excision
Lymph Node Ratio
Lymph Nodes* / pathology
Lymphatic Metastasis / pathology
Neoplasm Staging
Prognosis
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / pathology