loading page

Comparison of three lymph node staging methods for predicting outcome in patients with stage Ⅲ-Ⅳ hypopharyngeal squamous cell carcinoma
  • +3
  • Tian Wang,
  • Duo Zhang,
  • CHI-YAO HSUEH,
  • HUI-CHING LAU,
  • Lei Tao,
  • Wu Ping
Tian Wang
Fudan University Eye Ear Nose and Throat Hospital
Author Profile
Duo Zhang
Department of Otolaryngology–HNS, Eye, Ear, Nose and Throat Hospital
Author Profile
CHI-YAO HSUEH
Fudan University Eye Ear Nose and Throat Hospital
Author Profile
HUI-CHING LAU
Fudan University Eye Ear Nose and Throat Hospital
Author Profile
Lei Tao
Fudan University School of Medicine
Author Profile
Wu Ping
Fudan University Eye Ear Nose and Throat Hospital
Author Profile

Abstract

Background: Lymph node ratio (LNR), log odds of positive lymph nodes (LODDS), and the number of postoperative lymph node staging (pN) are prognostic indicators of various cancers. However, comparison of the prognostic values of these indicators remains unclear in hypopharyngeal squamous cell carcinoma (HPSCC). This study aims to compare the prognostic values of LNR, LODDS and pN in stage Ⅲ-Ⅳ HPSCC. Methods: We conducted a retrospective study on 166 patients with stage Ⅲ-Ⅳ HPSCC. LNR and LODDS were divided into two groups using X-tile version 3.6.1. Univariate and multivariate analyses of the risk of overall survival (OS) and disease-free survival (DFS) were performed using the log-rank (Mantel-Cox) test and the Cox proportional hazards model, respectively. We compared the prognostic value of LNR with that of LODDS and pN using receiver operating characteristic (ROC) curves. Results: According to the X-tile, the cut-off values are 0.11 for LNR and -0.91 for LODDS. LNR, LODDS, and pN were significantly correlated with DFS by univariate analysis (P < 0.05). Multivariate analysis demonstrated that LNR was an independent prognostic factor for DFS (P < 0.01). Multivariate analysis also revealed that postoperative tumour staging (pT) classification, LNR, and surgical margins were independent prognostic factors for OS. Compared with pN and LODDS, LNR showed a stronger predictive power for DFS. Conclusion: LNR may be a better predictor for DFS than pN and LODDS in stage Ⅲ-Ⅳ HPSCC patients. LNR in the highest tertile (≥ 0.11) may cause poor OS and DFS. LODDS in the highest tertile (≥-0.91) may cause poor DFS.