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Anales de Otorrinolaringología Mexicana

2021, Number 3

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Otorrinolaringología 2021; 66 (3)

Lymph node ratio, a prognostic factor in cancer of the oral cavity

Mesías-Andrade FC, Abrego-Vásquez JA, Gallegos-Hernández JF

Language: Spanish
References: 15
Page: 214-219
PDF size: 190.82 Kb.


ABSTRACT

Background: The relationship between the number of dissected and metastatic nodes in neck dissection is called lymph node ratio and is a prognostic factor in oral cavity cancer.
Objective: To know the prognostic value of lymph node ratio in patients with oral cavity cancer.
Materials and Methods: Descriptive, cross-sectional, observational and retrospective study done from 2015 to 2018 in patients with oral cavity cancer, lymph node ratio was compared with other prognostic variables and it was determined its association with tumor recurrence.
Results: One hundred twenty patients with oral cavity cancer were included, 58.3% were men; the mean age was of 62.7 years; 64.2% were cN0 and 37.8% cN+; 27.3% of the patients had lymph node metastases with nodal capsular rupture, the mean dissected nodes was 31.94, the mean of metastatic nodes was 2.18 and the mean of lymph node ratio was 0.069 (0.022 in cN0 and 0.13 in cN+). The rate of recurrence in patients with lymph node ratio › 0.069 was of 45% compared with 22% in patients with lymph node ratio ‹ 0.069.
Conclusions: Lymph node ratio is a prognostic factor in oral cavity cancer, although associated with the stage. Patients with high lymph node ratio (› 0.069) have a higher relapse rate and may be candidates for concomitant chemo-radiotherapy. The lymph node ratio can translate insufficient surgery or greater stage and aggressiveness of oral cavity cancer.


REFERENCES

  1. Gallegos-Hernández JF, Abrego-Vázquez JA, Olvera-Casas A, Minauro-Muñoz GG, Ortiz-Maldonado AL. Cervical metastasis of squamous cell carcinoma of the head and neck. Therapeutic options. Cir Cir 2019; 87: 141-145.

  2. Cadoni G, Giraldi L, Petrelli L, Pandolfini M, Giuliani M, Paludetti G, et al. Prognostic factors in head and neck cancer: a 10-year retrospective analysis in a single-institution in Italy. Acta Otorhinolaryngol Ital 2017; 37 (6): 458-466. doi: 10.14639/0392-100X-1246.

  3. González-Ramírez I, Irigoyen-Camacho ME, Ramírez.Amador V, Lizano-Soberón M, Carrillo-García A, García-Carrancá A, et al. Association between age and high-risk human papilloma virus in Mexican oral cancer patients. Oral Dis 2013; 19: 766-804. doi: 10.1111/odi.12071.

  4. Cruz-Moreira K, Huamán-Garaicoa F, Mena G. Knowledge of oral cancer among community served during the stomatological lesion prevention campaign conducted at Universidad Católica de Santiago de Guayaquil-Ecuador. Acta Odontol Latinoam 2017; 30: 113-117.

  5. Gallegos-Hernández JF, Hernández-Hernández DM, Flores-Díaz R, Sierra-Santiesteban I, Pichardo-Romero P, Arias-Ceballos H, et al. The number of sentinel nodes identified as prognostic factor in oral epidermoid cancer. Oral Oncol 2015; 41: 947-952. doi: 10.1016/j.oraloncology. 2005.05.010.

  6. Gil Z, Carlson DL, Boyle JO, Kraus DH, Shah JP, Shaha AR, et al. Lymph node density is a significant predictor of outcome in patients with oral cancer. Cancer 2009; 115: 5700-5710. doi: 10.1002/cncr.24631.

  7. Gallegos-Hernández JF. Node metastases of epidermoid carcinoma in the neck with unknown primary tumor: in the current era does it still exist? Cir Cir 2019; 87: 133-135.

  8. Gallegos JF. Factores clínicos e histológicos que repercuten en el pronóstico de los pacientes con cáncer de la cavidad oral. An Orl Mex 2017; 62 (3): 197-208.

  9. Hosni A, McMullen C, Hui-Huang S, Xu W, Su J, et al. Lymph node ratio relationship to regional failure and distant metastases in oral cavity cancer. Radiother Oncol 2017; 124: 225-231. doi: 10.1016/j.radonc.2017.06.018.

  10. Künzel J, Mantsopoulos K, Psychogios G, Grundtner P, Koch M, Iro H. Lymph node ratio as a valuable additional predictor of outcome in selected patients with oral cavity cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117: 677-684. doi: 10.1016/j.oooo.2014.02.032.

  11. Espinoza-Velazco A, González-Montoya A, Carbajal-López B. Cociente ganglionar como factor pronóstico de recurrencia tumoral en pacientes con carcinoma escamoso de cavidad oral. Cir Cir 2020; 88: 684-689.

  12. Patel S, Amit M, Yen T, Liao C, Chaturvedi P, Agarwal J, Kowalski L, Ebrahimi A, Clark J, Cernea C, Brandao S, Kreppel M, Zöller J, Fliss D, Fridman E, Bachar G, Shpitzer T, Bolzoni V, Patel P, Jonnalagadda S, Robbins K, Shah J, Gil Z. Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research. Br J Cancer 2013; 109: 2087-2095. doi: 10.1038/bjc.2013.570.

  13. Ding D, Stokes W, Eguchi M, Hararah M, Sumner W, Amini A, et al. Association between lymph node ratio and recurrence and survival outcomes in patients with oral cavity cancer. JAMA Otolaryngol Head Neck Surg 2019; 145: 53-61. oi: 10.1001/jamaoto.2018.2974.

  14. Sayed S, Sharma S, Rane P, Vaishampayan S, Talole S, Chaturvedi P, Chaukar D, Deshmukh A, Agarwal J, D’cruz, A. Can metastatic lymph node ratio (LNR) predict survival in oral cavity cancer patients? J Surg Oncol 2013; 108: 256-263. doi: 10.1002/jso.23387.

  15. Bharath VM, Balagopal PG, Nebu AG, Jayasudha AV, Iqbal AM, Sebastian P. Can metastatic lymph node ratio be used as an independent prognostic factor in carcinoma of the tongue? Gulf J Oncolog 2018;1:6-10.




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