Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 3/2012

01-03-2012 | Original Article

Risk stratification of oral cancer patients using a combined prognostic factor including lymph node density and biomarker

Authors: Ki-Yeol Kim, In-Ho Cha

Published in: Journal of Cancer Research and Clinical Oncology | Issue 3/2012

Login to get access

Abstract

Purpose

In this study, we aimed to validate the lymph node density (LND) as an independent prognostic factor of oral squamous cell carcinoma (OSCC) and identify a combined prognostic factor including LND, predicting better performance in risk stratification.

Methods

We reviewed the clinical, pathological variables and biomarker of 95 OSCC patients who underwent surgery. LND was calculated as the ratio of positive lymph nodes to total lymph nodes removed. Principle component analysis was performed to identify a combined predictor.

Results

Multivariate analysis showed that variables independently prognostic overall survival were IMP3 (hazard ratio [HR] = 3.01, 95% confidence interval [95% CI] = 1.17–7.75, P = 0.022) in a model without LND and were IMP3 (HR = 3.64, 95% CI = 1.38–9.58, P = 0.008) and LND (HR = 0.57, 95% CI = 0.57–1.75, P = 0.322; HR = 2.45, 95% CI = 1.20–4.97, P = 0.013) in a model with LND. The risk stratification using the combined prognostic factor was more significant (P = 0.00117) than the conventional staging system and biomarker.

Conclusions

The LND was shown to be an independent prognostic factor in OSCC, and a combined factor including LND may be used for risk stratification of OSCC patients, which displayed the best performance.
Literature
go back to reference Aprill C, Dwyer A, Bogduk N (1990) Cervical zygapophyseal joint pain patterns II: a clinical evaluation. Spine (Phila Pa 1976) 15:458–461CrossRef Aprill C, Dwyer A, Bogduk N (1990) Cervical zygapophyseal joint pain patterns II: a clinical evaluation. Spine (Phila Pa 1976) 15:458–461CrossRef
go back to reference Berger AC, Fierro M, Kairys JC, Berd D, Sato T, Andrel J, Hyslop T, Mastrangelo MJ (2011) Lymph node ratio is an important and independent prognostic factor for patients with stage III melanoma. J Surg Oncol. doi:10.1002/jso.22051 Berger AC, Fierro M, Kairys JC, Berd D, Sato T, Andrel J, Hyslop T, Mastrangelo MJ (2011) Lymph node ratio is an important and independent prognostic factor for patients with stage III melanoma. J Surg Oncol. doi:10.​1002/​jso.​22051
go back to reference Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefebvre JL, Greiner RH, Giralt J, Maingon P, Rolland F, Bolla M, Cognetti F, Bourhis J, Kirkpatrick A, van Glabbeke M (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952. doi:10.1056/NEJMoa032641 PubMedCrossRef Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefebvre JL, Greiner RH, Giralt J, Maingon P, Rolland F, Bolla M, Cognetti F, Bourhis J, Kirkpatrick A, van Glabbeke M (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952. doi:10.​1056/​NEJMoa032641 PubMedCrossRef
go back to reference Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, Ozsahin EM, Jacobs JR, Jassem J, Ang KK, Lefebvre JL (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27:843–850. doi:10.1002/hed.20279 PubMedCrossRef Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, Ozsahin EM, Jacobs JR, Jassem J, Ang KK, Lefebvre JL (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27:843–850. doi:10.​1002/​hed.​20279 PubMedCrossRef
go back to reference Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, Kish JA, Kim HE, Cmelak AJ, Rotman M, Machtay M, Ensley JF, Chao KS, Schultz CJ, Lee N, Fu KK (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944. doi:10.1056/NEJMoa032646 PubMedCrossRef Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, Kish JA, Kim HE, Cmelak AJ, Rotman M, Machtay M, Ensley JF, Chao KS, Schultz CJ, Lee N, Fu KK (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944. doi:10.​1056/​NEJMoa032646 PubMedCrossRef
go back to reference Ebrahimi A, Clark JR, Zhang WJ, Elliott MS, Gao K, Milross CG, Shannon KF (2011) Lymph node ratio as an independent prognostic factor in oral squamous cell carcinoma. Head Neck 33:1245–1251. doi:10.1002/hed.21600 PubMedCrossRef Ebrahimi A, Clark JR, Zhang WJ, Elliott MS, Gao K, Milross CG, Shannon KF (2011) Lymph node ratio as an independent prognostic factor in oral squamous cell carcinoma. Head Neck 33:1245–1251. doi:10.​1002/​hed.​21600 PubMedCrossRef
go back to reference Fukunaga K (1990) Introduction to statistical pattern recognition. Academic Press, Boston Fukunaga K (1990) Introduction to statistical pattern recognition. Academic Press, Boston
go back to reference Gavilan J, Prim MP, De Diego JI, Hardisson D, Pozuelo A (2000) Postoperative radiotherapy in patients with positive nodes after functional neck dissection. Ann Otol Rhinol Laryngol 109:844–848PubMed Gavilan J, Prim MP, De Diego JI, Hardisson D, Pozuelo A (2000) Postoperative radiotherapy in patients with positive nodes after functional neck dissection. Ann Otol Rhinol Laryngol 109:844–848PubMed
go back to reference Gil Z, Carlson DL, Boyle JO, Kraus DH, Shah JP, Shaha AR, Singh B, Wong RJ, Patel SG (2009) Lymph node density is a significant predictor of outcome in patients with oral cancer. Cancer 115:5700–5710. doi:10.1002/cncr.24631 PubMedCrossRef Gil Z, Carlson DL, Boyle JO, Kraus DH, Shah JP, Shaha AR, Singh B, Wong RJ, Patel SG (2009) Lymph node density is a significant predictor of outcome in patients with oral cancer. Cancer 115:5700–5710. doi:10.​1002/​cncr.​24631 PubMedCrossRef
go back to reference Kassouf W, Leibovici D, Munsell MF, Dinney CP, Grossman HB, Kamat AM (2006) Evaluation of the relevance of lymph node density in a contemporary series of patients undergoing radical cystectomy. J Urol 176:53–57; discussion 57. doi:10.1016/S0022-5347(06)00510-6 Kassouf W, Leibovici D, Munsell MF, Dinney CP, Grossman HB, Kamat AM (2006) Evaluation of the relevance of lymph node density in a contemporary series of patients undergoing radical cystectomy. J Urol 176:53–57; discussion 57. doi:10.​1016/​S0022-5347(06)00510-6
go back to reference Kassouf W, Agarwal PK, Herr HW, Munsell MF, Spiess PE, Brown GA, Pisters L, Grossman HB, Dinney CP, Kamat AM (2008) Lymph node density is superior to TNM nodal status in predicting disease-specific survival after radical cystectomy for bladder cancer: analysis of pooled data from MDACC and MSKCC. J Clin Oncol 26:121–126. doi:10.1200/JCO.2007.12.9247 PubMedCrossRef Kassouf W, Agarwal PK, Herr HW, Munsell MF, Spiess PE, Brown GA, Pisters L, Grossman HB, Dinney CP, Kamat AM (2008) Lymph node density is superior to TNM nodal status in predicting disease-specific survival after radical cystectomy for bladder cancer: analysis of pooled data from MDACC and MSKCC. J Clin Oncol 26:121–126. doi:10.​1200/​JCO.​2007.​12.​9247 PubMedCrossRef
go back to reference Li S, Cha J, Kim J, Kim KY, Kim HJ, Nam W, Cha IH (2011) Insulin-like growth factor II mRNA-binding protein 3: a novel prognostic biomarker for oral squamous cell carcinoma. Head Neck 33:368–374. doi:10.1002/hed.21457 PubMedCrossRef Li S, Cha J, Kim J, Kim KY, Kim HJ, Nam W, Cha IH (2011) Insulin-like growth factor II mRNA-binding protein 3: a novel prognostic biomarker for oral squamous cell carcinoma. Head Neck 33:368–374. doi:10.​1002/​hed.​21457 PubMedCrossRef
go back to reference Margel D, Harel A, Yossepowitch O, Baniel J (2009) A novel algorithm to improve pathologic stage prediction of clinically organ-confined muscle-invasive bladder cancer. Cancer 115:1459–1464. doi:10.1002/cncr.24138 PubMedCrossRef Margel D, Harel A, Yossepowitch O, Baniel J (2009) A novel algorithm to improve pathologic stage prediction of clinically organ-confined muscle-invasive bladder cancer. Cancer 115:1459–1464. doi:10.​1002/​cncr.​24138 PubMedCrossRef
go back to reference Ooki A, Yamashita K, Kobayashi N, Katada N, Sakuramoto S, Kikuchi S, Watanabe M (2007) Lymph node metastasis density and growth pattern as independent prognostic factors in advanced esophageal squamous cell carcinoma. World J Surg 31:2184–2191. doi:10.1007/s00268-007-9198-9 PubMedCrossRef Ooki A, Yamashita K, Kobayashi N, Katada N, Sakuramoto S, Kikuchi S, Watanabe M (2007) Lymph node metastasis density and growth pattern as independent prognostic factors in advanced esophageal squamous cell carcinoma. World J Surg 31:2184–2191. doi:10.​1007/​s00268-007-9198-9 PubMedCrossRef
go back to reference Parsons JT, Mendenhall WM, Stringer SP, Cassisi NJ, Million RR (1997) An analysis of factors influencing the outcome of postoperative irradiation for squamous cell carcinoma of the oral cavity. Int J Radiat Oncol Biol Phys 39:137–148PubMed Parsons JT, Mendenhall WM, Stringer SP, Cassisi NJ, Million RR (1997) An analysis of factors influencing the outcome of postoperative irradiation for squamous cell carcinoma of the oral cavity. Int J Radiat Oncol Biol Phys 39:137–148PubMed
go back to reference Rudoltz MS, Benammar A, Mohiuddin M (1995) Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy? Int J Radiat Oncol Biol Phys 31:503–508PubMedCrossRef Rudoltz MS, Benammar A, Mohiuddin M (1995) Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy? Int J Radiat Oncol Biol Phys 31:503–508PubMedCrossRef
go back to reference Shah JP (1990) Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg 160:405–409PubMedCrossRef Shah JP (1990) Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg 160:405–409PubMedCrossRef
go back to reference Shingaki S, Takada M, Sasai K, Bibi R, Kobayashi T, Nomura T, Saito C (2003) Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 185:278–284PubMedCrossRef Shingaki S, Takada M, Sasai K, Bibi R, Kobayashi T, Nomura T, Saito C (2003) Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 185:278–284PubMedCrossRef
go back to reference Shrime MG, Bachar G, Lea J, Volling C, Ma C, Gullane PJ, Gilbert RW, Irish JC, Brown DH, Goldstein DP (2009a) Nodal ratio as an independent predictor of survival in squamous cell carcinoma of the oral cavity. Head Neck 31:1482–1488. doi:10.1002/hed.21114 PubMedCrossRef Shrime MG, Bachar G, Lea J, Volling C, Ma C, Gullane PJ, Gilbert RW, Irish JC, Brown DH, Goldstein DP (2009a) Nodal ratio as an independent predictor of survival in squamous cell carcinoma of the oral cavity. Head Neck 31:1482–1488. doi:10.​1002/​hed.​21114 PubMedCrossRef
go back to reference Shrime MG, Ma C, Gullane PJ, Gilbert RW, Irish JC, Brown DH, Goldstein DP (2009b) Impact of nodal ratio on survival in squamous cell carcinoma of the oral cavity. Head Neck 31:1129–1136. doi:10.1002/hed.21073 PubMedCrossRef Shrime MG, Ma C, Gullane PJ, Gilbert RW, Irish JC, Brown DH, Goldstein DP (2009b) Impact of nodal ratio on survival in squamous cell carcinoma of the oral cavity. Head Neck 31:1129–1136. doi:10.​1002/​hed.​21073 PubMedCrossRef
Metadata
Title
Risk stratification of oral cancer patients using a combined prognostic factor including lymph node density and biomarker
Authors
Ki-Yeol Kim
In-Ho Cha
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Journal of Cancer Research and Clinical Oncology / Issue 3/2012
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-011-1129-3

Other articles of this Issue 3/2012

Journal of Cancer Research and Clinical Oncology 3/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.