Influence of different methods for classification of lymph node metastases on the survival of patients with oral squamous cell carcinoma.

BACKGROUND: Despite the advances in the classification of oral squamous cell carcinoma (OSCC) based on its extension by the TNM system, there is still a need for methods to better classify the patients to predict prognosis and indicate adjuvant therapy. OBJECTIVES: To analyze the influence of the number of positive lymph nodes (PN), lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) in survival of patients with OSCC. METHODS: Clinicopathologic data from patients with OSCC who were treated with curative purposes by surgery and neck dissection (ND) with or without subsequent adjuvant therapies from 1991 to 2015 was retrospectively assessed. The impact of the PN, LNR, LODDS, and other variables on overall survival (OS) and disease-free survival (DFS) was analyzed in univariate and multivariate analyses. RESULTS: One hundred nineteen patients were included in this study. In the univariate analysis the PN had a significant impact on OS (p = 0.001) and DFS (p = 0.020), and the LNR had a significant impact on the OS (p = 0.042). In the multivariate analysis with other relevant clinicopathologic variables, the PN was the only significantly independent factor influencing in the OS (p = 0.017) but not in DFS (p = 0.096). CONCLUSIONS: The PN is an independent prognostic indicator for OS and DFS in patients with OSCC and has the potential to aggregate the current AJCC classification. The LNR has potential to be an important prognostic indicator, but the methods for this classification require lapidation. The LODDS did not demonstrate prognostic potential.

Potential of lymph-node ratio as a prognostic factor for patients with oral squamous cell carcinoma.

BACKGROUND: To analyze the influence of the lymph node ratio (LNR) in survival of patients with OSCC METHODS: Clinicopathologic data from patients with OSCC who were treated with curative surgery and neck dissection (ND) with or without adjuvant therapies from 1991 to 2015 was retrospectively assessed. The impact of LNR and other variables on overall survival (OS) and disease-free survival (DFS) was analyzed in univariate and multivariate analyses. RESULTS: One hundred nineteen patients were included. In the univariate analysis the LNR had a significant impact on OS (p = 0.01) and DFS (p = 0.01). In the multivariate analysis, the LNR was the only significantly independent factor influencing in the OS (p = 0.03). The adjuvant therapies did not influence on the OS (p = 0.42) and DFS (p = 0.10). CONCLUSIONS: The LNR is an independent prognostic factor in patients with OSCC. The LNR alone is not recommended to indicate the performance of adjuvant therapies.

Prognosis impact of perineural invasion in advanced stage oral squamous cell carcinoma / Impacto do prognóstico da invasão perineural no carcinoma espinocelular de boca em estágio avançado

Apesar de pesquisas recentes mostrarem baixa sobrevida em pacientes oncológicos que tiveram invasão perineural (IPN), pouco se sabe sobre a força do IPN relacionada à sobrevida do carcinoma espinocelular (CEC) de boca e em relação a suas variáveis clínico-patológicas. Os objetivos específicos do estudo foram medir o impacto do IPN na sobrevida do CEC de boca, bem como a correlação entre as características clínico-patológicas do paciente diagnosticado com CEC de boca com o IPN em pacientes tratados cirurgicamente. Foi realizado um estudo retrospectivo envolvendo 101 pacientes submetidos ao tratamento cirúrgico com ou sem associação de terapia adjuvante entre os anos de 1994 e 2016. Todas as variáveis foram inseridas simultaneamente no modelo de cox para cada modelo de sobrevida e na tabulação cruzada para avaliar a relação do IPN com as variáveis do CEC de boca. A significância estatística para o estudo foi estabelecida em um valor de P inferior a 0,05. A variável de interesse IPN provou ser preditora de sobrevida global (HR, 3,38; IC 95%, 0,139-0,624; P = 0,004) e sobrevida específica da doença (HR, 2,95; IC 95% 0,137-0,810; P=0,019). O IPN também mostrou relação com tratamento (P = 0,011) na análise de correlação. A invasão perineural foi considerada uma variável independente na sobrevida específica e global de pacientes com CEC de boca. Outros fatores relacionados à sensibilidade da avaliação do padrão de invasão perineural no CEC de boca ainda permanecem desconhecidos(AU)

Despite recent research showing low survival in cancer patients who had perineural invasion (PNI), little is known about the strength of the PNI related to oral squamous cell carcinoma (OSCC) survival and in relation to its clinicopathological variables. The specific objectives of the study were to measure the impact of the PNI on the survival of oral SCC, as well as the correlation between the clinicopathological characteristics of the patient diagnosed with OSCC of the mouth with the PNI in surgically treated patients. A retrospective study was carried out involving 101 patients who underwent surgical treatment with or without the association of adjuvant therapy between the years 1994 and 2016. All variables were entered simultaneously in the cox model for each survival model and in the cross-tabulation to evaluate the relationship between the PNI and the OSCC by mouth variables. Statistical significance for the study was established at a P value of less than 0.05. The PNI variable of interest proved to be a predictor of overall survival (HR, 3.38; 95% CI, 0.139-0.624; P = 0.004) and disease-specific survival (HR, 2.95; 95% CI 0.137-0.810; P =0.019). The PNI also showed a relationship with treatment (P = 0.011) in the correlation analysis. Perineural invasion was considered an independent variable in the specific and overall survival of patients with OSCC. Other factors related to the sensitivity of the assessment of the perineural invasion pattern in OSCC of the mouth still remain unknown(AU)