scholarly journals The log odds of positive neck lymph nodes is a superior lymph node predictor for overall survival in head and neck cancer: a population-based analysis in Germany

2021 ◽  
Author(s):  
Mussab Kouka ◽  
Elisa Al-Ahmar ◽  
Jens Büntzel ◽  
Holger Kaftan ◽  
Daniel Böger ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Real Life ◽  
Stage Iv ◽  
Cancer Registries ◽  
Population Based ◽  
Log Odds

Abstract Background This population-based study investigated the influence of different lymph node (LN) classifications on overall survival (OS) in head and neck cancer (HNC). Methods 401 patients (median age: 57 years; 47% stage IV) of the Thuringian cancer registries with diagnosis of a primary HNC receiving a neck dissection (ND) in 2009 and 2010 were included. OS was assessed in relation to total number of LN removed, number of positive LN, LN ratio, and log odds of positive LN (LODDS). Results Mean number of LODDS was 0–0.96 ± 0.57. When limiting the multivariate analysis to TNM stage, only the UICC staging (stage IV: HR 9.218; 95% CI 2.721–31.224; p < 0.001) and LODDS >  – 1.0 (HR 2.120; 95% CI 1.129–3.982; p = 0.019) were independently associated with lower OS. Conclusion LODDS was an independent and superior predictor for OS in HNC in a population-based setting with representative real-life data.

Population assessment of head and neck cancer outcomes by race and HPV status in chance.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6045-6045 ◽  
Author(s):  
Siddharth Sheth ◽  
Doug Farquhar ◽  
Angela Mazul ◽  
David N. Hayes ◽  
Jose Zevallos ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Oral Cavity ◽  
Racial Disparities ◽  
Head And Neck ◽  
Neck Cancer ◽  
Population Based ◽  
Black Patients ◽  
Hpv Status ◽  
Pharynx Cancer

6045 Background: Growing literature suggests that racial disparities exist in patients with head and neck squamous cell carcinoma (HNSCC). Currently, there are many hospital-based cohorts assessing racial disparities, however only a limited number of population-based cohorts exist. This study aims to explore the association between clinical characteristics and patient demographics with overall survival by race and HPV status. Methods: Patients were identified from the Carolina Head and Neck Cancer Study (CHANCE), a population based case-control study with enrollment from 2001-2006 in North Carolina. Vital status was determined by linkage with the National Death Index. Survival was considered at 5 years after diagnosis or study enrollment. We used Kaplan-Meyer analyses and Cox proportional hazards regression modeling to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI). Results: A total of 1361 HNSCC patients with no baseline metastasis and adequate survival time were identified. Of these, 1010 patients were white while 351 patients were black. Black patients were statistically more likely to be younger at age of diagnosis, have a history of tobacco or alcohol use, be uninsured, and not have completed high school (p-value < 0.001). In an unadjusted cox regression analysis, blacks had 1.50 times (95% CI 1.01-1.57) decreased overall survival than whites. Adjusting for gender, stage of disease, age, treatment, and smoking status, this relationship remained (HR 1.30, CI 1.1-1.6). In a subset analysis of male patients by disease site, there was decreased overall survival in black patients in oral cavity cases (p < 0.01). This relationship trended towards significant in pharynx cancer (p = 0.054) and was not found in laryngeal cancer. In pharyngeal cases only, there was decreased overall survival in black patients with HPV+ disease (p = 0.03) but not in HPV- cases (p = 0.33). Conclusions: This is the first population-based study that confirms racial disparities in HPV+ HNSCC. We also found worse overall survival prognosis for black patients with oral cavity cancer and a similar trend in pharynx cancer. Further studies are needed to evaluate if this difference is driven by either biological or socioeconomic factors.

Lymph Node Count From Neck Dissection Predicts Mortality in Head and Neck Cancer

2016 ◽  
Vol 34 (32) ◽  
pp. 3892-3897 ◽  
Author(s):  
Vasu Divi ◽  
Michelle M. Chen ◽  
Brian Nussenbaum ◽  
Kim F. Rhoads ◽  
Davud B. Sirjani ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
National Cancer Database ◽  
Node Negative ◽  
Lymph Node Count ◽  
Node Positive

Purpose Multiple smaller studies have demonstrated an association between overall survival and lymph node (LN) count from neck dissection in patients with head and neck cancer. This is a large cohort study to examine these associations by using a national cancer database. Patients and Methods The National Cancer Database was used to identify patients who underwent upfront nodal dissection for mucosal head and neck squamous cell carcinoma between 2004 and 2013. Patients were stratified by LN count into those with < 18 nodes and those with ≥ 18 nodes on the basis of prior work. A multivariable Cox proportional hazards regression model was constructed to predict hazard of mortality. Stratified models predicted hazard of mortality both for patients who were both node negative and node positive. Results There were 45,113 patients with ≥ 18 LNs and 18,865 patients with < 18 LNs examined. The < 18 LN group, compared with the ≥ 18 LN group, had more favorable tumor characteristics, with a lower proportion of T3 and T4 lesions (27.9% v 39.8%), fewer patients with positive nodes (46.6% v 60.5%), and lower rates of extracapsular extension (9.3% v 15.1%). Risk-adjusted Cox models predicting hazard of mortality by LN count showed an 18% increased hazard of death for patients with < 18 nodes examined (hazard ratio [HR] 1.18; 95% CI, 1.13 to 1.22). When stratified by clinical nodal stage, there was an increased hazard of death in both groups (node negative: HR, 1.24; 95% CI, 1.17 to 1.32; node positive: HR, 1.12; 95% CI, 1.05 to 1.19). Conclusion The results of our study demonstrate a significant overall survival advantage in both patients who are clinically node negative and node positive when ≥ 18 LNs are examined after neck dissection, which suggests that LN count is a potential quality metric for neck dissection.

The influence of nodal yield in neck dissections on lymph node ratio in head and neck cancer

Oral Oncology ◽  
2014 ◽  
Vol 50 (1) ◽  
pp. 59-64 ◽  
Author(s):  
C.C.M. Marres ◽  
M. de Ridder ◽  
I. Hegger ◽  
M.L.F. van Velthuysen ◽  
M. Hauptmann ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Lymph Node Ratio ◽  
Node Ratio ◽  
Nodal Yield

scholarly journals Bioelectrical impedance phase angle as a prognostic indicator of survival in head-and-neck cancer

2016 ◽  
Vol 23 (5) ◽  
pp. 481 ◽  
Author(s):  
M.S. Wladysiuk ◽  
R. Mlak ◽  
K. Morshed ◽  
W. Surtel ◽  
A. Brzozowska ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Phase Angle ◽  
Neck Cancer ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Neck Surgery ◽  
Department Head ◽  
Nutrition Status

Background Phase angle could be an alternative to subjective global assessment for the assessment of nutrition status in patients with head-and-neck cancer.Methods We prospectively evaluated a cohort of 75 stage iiib and iv head-and-neck patients treated at the Otolaryngology Department, Head and Neck Surgery, Medical University of Lublin, Poland. Bioelectrical impedance analysis was performed in all patients using an analyzer that operated at 50 kHz. The phase angle was calculated as reactance divided by resistance (Xc/R) and expressed in degrees. The Kaplan–Meier method was used to calculate survival.Results Median overall survival in the cohort was 32.0 months. At the time of analysis, 47 deaths had been recorded in the cohort (62.7%). The risk of shortened overall survival was significantly higher in patients whose phase angle was less than 4.733 degrees than in the remaining patients (19.6 months vs. 45 months, p = 0.0489; chi-square: 3.88; hazard ratio: 1.8856; 95% confidence interval: 1.0031 to 3.5446).Conclusions Phase angle might be prognostic of survival in patients with advanced head-and-neck cancer. Further investigation in a larger population is required to confirm our results.

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