Correlation of Lymph Node Density with Negative Outcome Predictors in Oral and Maxillofacial Squamous Cell Carcinoma

Publication date: Available online 28 March 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Roderick Youngdo Kim, Brent Benson Ward, Hans C. Brockhoff, Joseph I. Helman, Thomas M. Braun, Christos A. Skouteris
PurposeLymph node density is defined as the number of positive lymph nodes per total number of excised lymph nodes. In oral and maxillofacial cancer, there are recent data showing that increased lymph node density leads to worse outcomes for patients. However, we are lacking data correlating lymph node density with other known risk parameters. Our study aims to identify if a direct correlation exists between cervical lymph node density, depth of invasion, perineural invasion, and extracapsular tumor spread.Material and MethodsA retrospective chart review was undertaken to include all patients who underwent neck dissection with resection of primary oral and maxillofacial squamous cell carcinoma, treated from January 2009 through July 2014. After exclusion criteria, 286 patients in total were identified. Primary tumor depth of invasion, perineural invasion, as well as lymph node status including extracapsular spread were obtained from the standard pathology report. Descriptive statistics were applied. Association between two continuous tumor characteristics was summarized with Pearson's correlation coefficient, while association between a continuous and binary tumor characteristic was summarized with a two-sample t-test. Statistical significance for the study was set at a p-value less than 0.05.ResultsMean age at the time of surgery was 63.9 ± 12.5 years. The final study included 169 males and 117 females (N=286). The mean depth of invasion was 12.3 ± 11 mm, and ranged from 1 to 69 mm. Mean lymph node density was 0.04 ± 0.1, and ranged from 0 to 0.81.There was a positive association between the lymph node density and depth of tumor invasion; the Pearson's correlation coefficient was r=0.21 (p<0.001). Tumors with perineural invasion had a statistically significant difference in mean lymph node density, 0.074 for positive versus 0.024 for negative (p<0.001). There was also significant association in mean lymph node density with presence of extracapsular spread, 0.143 for positive and 0.010 for negative (; p<0.001).ConclusionsStatistically significant, positively linear relationship between lymph node density, depth of invasion, perineural invasion, and extracapsular spread were identified. Lymph node density may have prognostic implications, as it is statistically correlated with other known prognostic features that lead to poor outcomes. Lymph node density may be an important feature to capture in future prospective trials. Pathology standards would be crucial in this endeavor.



from #ENT via xlomafota13 on Inoreader http://ift.tt/1RGd5pH
via IFTTT