Universität zu Köln

Ebrahimi, Ardalan, Gil, Ziv, Amit, Moran, Yen, Tzu-Chen, Liao, Chun-Ta, Chaturvedi, Pankaj, Agarwal, Jai Prakash, Kowalski, Luiz P., Kohler, Hugo F., Kreppel, Matthias, Cernea, Claudio R., Brandao, Jose, Bachar, Gideon, Villaret, Andrea Bolzoni, Fliss, Dan, Fridman, Eran, Robbins, K. Thomas, Shah, Jatin P., Patel, Snehal G. and Clark, Jonathan R. (2014). The Prognosis of N2b and N2c Lymph Node Disease in Oral Squamous Cell Carcinoma Is Determined by the Number of Metastatic Lymph Nodes Rather Than Laterality. Cancer, 120 (13). S. 1968 - 1975. HOBOKEN: WILEY-BLACKWELL. ISSN 1097-0142

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Abstract

BACKGROUND: A study was conducted to assess for prognostic heterogeneity within the N2b and N2c classifications for oral cancer based on the number of metastatic lymph nodes and to determine whether laterality of neck disease provides additional prognostic information. METHODS: An international multicenter study of 3704 patients with oral cancer undergoing surgery with curative intent was performed. The endpoints of interest were disease-specific survival and overall survival. Model fit was assessed by the Akaike Information Criterion and comparison of models with and without the covariate of interest using a likelihood ratio test. RESULTS: The median number of metastatic lymph nodes was significantly higher in patients with N2c disease compared to those with N2b disease (P < .001). In multivariable analyses stratified by study center, the addition of the number of metastatic lymph nodes improved model fit beyond existing N classification. Next, the authors confirmed significant heterogeneity in prognosis based on the number of metastatic lymph nodes (<= 2, 3-4, and >= 5) in patients with both N2b and N2c disease (P < .001). A proposed reclassification combining N2b and N2c disease based on the number of metastatic lymph nodes demonstrated significant improvement in prognostic accuracy compared with the American Joint Committee on Cancer staging system, and no improvement was noted with the addition of a covariate for contralateral or bilateral neck disease (P = .472). CONCLUSIONS: The prognosis of patients with oral cancer with N2b and N2c disease appears to be similar after adequate adjustment for the burden of lymph node metastases, irrespective of laterality. Based on this finding, the authors propose a modified lymph node staging system that requires external validation before implementation in clinical practice. (C) 2014 American Cancer Society.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ebrahimi, Ardalan UNSPECIFIED UNSPECIFIED UNSPECIFIED Gil, Ziv UNSPECIFIED UNSPECIFIED UNSPECIFIED Amit, Moran UNSPECIFIED UNSPECIFIED UNSPECIFIED Yen, Tzu-Chen UNSPECIFIED UNSPECIFIED UNSPECIFIED Liao, Chun-Ta UNSPECIFIED UNSPECIFIED UNSPECIFIED Chaturvedi, Pankaj UNSPECIFIED UNSPECIFIED UNSPECIFIED Agarwal, Jai Prakash UNSPECIFIED UNSPECIFIED UNSPECIFIED Kowalski, Luiz P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kohler, Hugo F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreppel, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Cernea, Claudio R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brandao, Jose UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachar, Gideon UNSPECIFIED UNSPECIFIED UNSPECIFIED Villaret, Andrea Bolzoni UNSPECIFIED UNSPECIFIED UNSPECIFIED Fliss, Dan UNSPECIFIED UNSPECIFIED UNSPECIFIED Fridman, Eran UNSPECIFIED UNSPECIFIED UNSPECIFIED Robbins, K. Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah, Jatin P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Patel, Snehal G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Clark, Jonathan R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-435192
DOI:	10.1002/cncr.28686
Journal or Publication Title:	Cancer
Volume:	120
Number:	13
Page Range:	S. 1968 - 1975
Date:	2014
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1097-0142
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STAGE GROUPINGS; NECK; CAVITY; HEAD; CANCER Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43519