Comparison of three lymph node staging methods for predicting outcome in
patients with stage Ⅲ-Ⅳ hypopharyngeal squamous cell carcinoma
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.