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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2017

01-06-2017 | Head and Neck Oncology

Lymph Node Ratio Predicts Recurrence and Survival for Patients with Resectable Stage 4 Hypopharyngeal Cancer

Authors: Wu-Chia Lo, MD, Chen-Tu Wu, MD, Cheng-Ping Wang, MD, Tsung-Lin Yang, MD, PhD, Pei-Jen Lou, MD, PhD, Jeng-Yuh Ko, MD, PhD, Yih-Leong Chang, MD

Published in: Annals of Surgical Oncology | Issue 6/2017

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Abstract

Background

This study aimed to investigate the clinicopathologic prognostic predictors of stage 4 hypopharyngeal cancer and to extend the traditional tumor-node-metastasis classification system to advance its predictive ability.

Methods

The study enrolled 120 patients with pathologically stage 4 hypopharyngeal cancer treated with pharyngolaryngectomy and neck dissection between 2001 and 2007.

Results

The study showed a 5-year overall survival (OS) of 44.6%, a disease-specific survival (DSS) of 51.6%, and a disease-free survival (DFS) of 48% for all the patients. In the multivariate analysis, a lymph node (LN) ratio of 0.113 or higher was a significant poor prognostic factor for OS (hazard ratio [HR] 1.89; 95% confidence interval [CI] 1.17–3.05; p = 0.009), DSS (HR 2.17; 95% CI 1.29–3.64; p = 0.003), and DFS (HR, 2.24; 95% CI 1.12–4.52; p = 0.024) in stage 4 hypopharyngeal cancer. In addition, pretreatment neutrophil–lymphocyte ratio, lymphovascular invasion, and margin status also were predictors of survival outcomes. Furthermore, the study found that disease recurrence differed significantly between the patients with a LN ratio of 0.113 or higher (68.2%) and those with a LN ratio lower than 0.113 (39.5%) (p = 0.002).

Conclusions

A LN ratio of 0.113 or higher is a strong predictor of disease recurrence and survival for patients with stage 4 hypopharyngeal cancer.
Appendix
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Literature
1.
Spector JG, Sessions DG, Haughey BH, et al. Delayed regional metastases, distant metastases, and second primary malignancies in squamous cell carcinomas of the larynx and hypopharynx. Laryngoscope. 2001;111:1079–87.CrossRefPubMed
2.
Joo YH, Cho KJ, Kim SY, Kim MS. Prognostic significance of lymph node density in patients with hypopharyngeal squamous cell carcinoma. Ann Surg Oncol. 2015;22(Suppl 3):S1014–9.CrossRefPubMed
3.
Yu Y, Wang XL, Xu ZG, Fan CC, Li Q. Prognostic value of lymph node ratio in hypopharyngeal squamous cell carcinoma after chemoradiotherapy. Chin Med J. 2013;126:4139–44.PubMed
4.
Bernstein JM, Andrews TD, Slevin NJ, West CM, Homer JJ. Prognostic value of hypoxia-associated markers in advanced larynx and hypopharynx squamous cell carcinoma. Laryngoscope. 2015;125:E8–15.CrossRefPubMed
5.
Varghese BT, Babu S, Desai KP, et al. Prospective study of outcomes of surgically treated larynx and hypopharyngeal cancers. Indian J Cancer. 2014;51:104–8.CrossRefPubMed
6.
Yang CJ, Kim DY, Lee JH, et al. Prognostic value of total tumor volume in advanced-stage laryngeal and hypopharyngeal carcinoma. J Surg Oncol. 2013;108:509–15.CrossRefPubMed
7.
Varghese BT, Sebastian P, Mathew A. Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx: a follow-up study. Acta Otolaryngol. 2009;129:1480–5.CrossRefPubMed
8.
Pezier TF, Nixon IJ, Joshi A, et al. Factors predictive of outcome following primary total laryngectomy for advanced squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2014;271:2503–9.CrossRefPubMed
9.
Teymoortash A, Bohne F, Kissing L, et al. Oncological and surgical outcome of total laryngectomy in combination with neck dissection in the elderly. Eur Arch Otorhinolaryngol. 2016;273:1825–33.CrossRefPubMed
10.
Gupta T, Chopra S, Agarwal JP, et al. Squamous cell carcinoma of the hypopharynx: single-institution outcome analysis of a large cohort of patients treated with primary non-surgical approaches. Acta Oncol. 2009;48:541–8.CrossRefPubMed
11.
Chu PY, Li WY, Chang SY. Clinical and pathologic predictors of survival in patients with squamous cell carcinoma of the hypopharynx after surgical treatment. Ann Otol Rhinol Laryngol. 2008;117:201–6.PubMed
12.
Nakahira M, Sugasawa M, Matsumura S, et al. Prognostic role of the combination of platelet count and neutrophil-lymphocyte ratio in patients with hypopharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2016;273:3863–7.CrossRefPubMed
13.
Song Y, Liu H, Gao L, et al. Preoperative neutrophil-to-lymphocyte ratio as prognostic predictor for hypopharyngeal squamous cell carcinoma after radical resections. J Craniofac Surg. 2015;26:e137–40.CrossRefPubMed
14.
Omura G, Ando M, Saito Y, Kobayashi K, Yamasoba T, Asakage T. Disease control and clinicopathological prognostic factors of total pharyngolaryngectomy for hypopharyngeal cancer: a single-center study. Int J Clin Oncol. 2015;20:290–7.CrossRefPubMed
15.
Ikeguchi M. Glasgow prognostic score and neutrophil-lymphocyte ratio are good prognostic indicators after radical neck dissection for advanced squamous cell carcinoma in the hypopharynx. Langenbecks Arch Surg. 2016;401:861–6.CrossRefPubMed
16.
Taguchi T, Nishimura G, Takahashi M, et al. Treatment results and prognostic factors for advanced squamous cell carcinoma of the hypopharynx treated with concurrent chemoradiotherapy. Cancer Chemother Pharmacol. 2014;73:1147–54.CrossRefPubMed
17.
Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 2000;355:949–55.CrossRefPubMed
18.
Posner MR, Hershock DM, Blajman CR, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med. 2007;357:1705–15.CrossRefPubMed
19.
Dequanter D, Zouaoui Boudjeltia K, Shahla M, Aubert C, Lothaire P. Prognostic value of lymph node ratio for locoregional failure in patients with advanced head and neck cancers. Minerva Stomatol. 2016;65:39–42.PubMed
20.
Ryu IS, Roh JL, Cho KJ, Choi SH, Nam SY, Kim SY. Lymph node density as an independent predictor of cancer-specific mortality in patients with lymph node-positive laryngeal squamous cell carcinoma after laryngectomy. Head Neck. 2015;37:1319–25.CrossRefPubMed
21.
Kim SY, Nam SY, Choi SH, Cho KJ, Roh JL. Prognostic value of lymph node density in node-positive patients with oral squamous cell carcinoma. Ann Surg Oncol. 2011;18:2310–17.CrossRefPubMed
22.
Shrime MG, Bachar G, Lea J, et al. Nodal ratio as an independent predictor of survival in squamous cell carcinoma of the oral cavity. Head Neck. 2009;31:1482–8.CrossRefPubMed
23.
Ho CM, Ng WF, Lam KH, Wei WI, Yuen AP. Radial clearance in resection of hypopharyngeal cancer: an independent prognostic factor. Head Neck. 2002;24:181–90.CrossRefPubMed
24.
Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88:218–30.CrossRefPubMed
Metadata
Title
Lymph Node Ratio Predicts Recurrence and Survival for Patients with Resectable Stage 4 Hypopharyngeal Cancer
Authors
Wu-Chia Lo, MD
Chen-Tu Wu, MD
Cheng-Ping Wang, MD
Tsung-Lin Yang, MD, PhD
Pei-Jen Lou, MD, PhD
Jeng-Yuh Ko, MD, PhD
Yih-Leong Chang, MD
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5770-1

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