Prognostic Significance of Lymph Node Metastases and Ratio in Laryngeal Squamous Cell Carcinoma

Background The lymph node metastases (LNM) and the lymph node ratio (LNR) were shown to be prognostic factors in head and neck cancer. The purpose of this study was to investigate the prognostic significance of the LNM and LNR in patients with laryngeal squamous cell carcinoma (LSCC). Methods All patients undergoing resection of laryngeal cancer at the First Affiliated Hospital of Chongqing Medical University between March 2011 and December 2018 were reviewed. Univariate and multivariate analyses were performed using log-rank and Cox proportional hazard models, and survival curves estimated using the Kaplan-Meier method. Results Of 670 patients with LSCC, the median overall survival (OS) of was 42.2 months, and 3-year and 5-year OS rates were respectively 92.9 ± 1.1% and 86.1 ± 1.7%. 12.69% (85/670) were pathological nodal positive (pN+). LNM was associated with tumor site, T stage and differentiation degree (p < 0.05). And the 5-year OS rates in the pathological nodal negative (pN-) and pN + groups were 88.7± 1.7% and 69.9 ± 5.9%, respectively (p = 0.000), and the presence of pN + was the most significant prognostic factor for survival. Furthermore, the 5-year OS of patients with 1 to 3 positive LN and 4 or more positive LN were 64.6±8.1% and 44.9 ± 15.2%, respectively (p = 0.032). Additionally, LNR examination did not reach significance in our study. However, it demonstrates that increasing LNR was associated with worsening survival. Conclusion LNM is an independent prognostic factor in LSCC, and increasing number of positive LN and LNR in patients portend a poor prognosis.