Lymph node ratio (LNR) as a complementary staging system to TNM staging in salivary gland cancer

Bo Wen Lei, Jia Qian Hu, Peng Cheng Yu, Yu Long Wang, Wen Jun Wei, Ji Zhu, Xiao Shi, Ning Qu, Zhong Wu Lu, Qing Hai Ji

Research output: Contribution to journalArticle

Abstract

Purpose: The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of multiple human malignancies has been reported. We aim to evaluate its value in salivary gland cancer (SGC). Methods: Records of SGC patients from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 4262) and Fudan University Shanghai Cancer Center (FUSCC, validating set, N = 154) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile. Results: Optimal LNR cutoff points classified patients into four risk groups, R0, R1 (≤ 0.17), R2 (0.17–0.56) and R3 (> 0.56), corresponding to 5-year cause-specific survival in SEER patients of 88.6%, 57.2%, 53.1% and 39.7%, disease-free survival in FUSCC patients of 69.2%, 63.3%, 34.6% and 0%, and disease-specific survival in FUSCC patients of 92.3%, 90.0%, 71.4% and 0%, respectively. Compared with TNM staging, TNM + R staging showed smaller AIC values and higher C-index values in the Cox regression model in both patient sets. Conclusions: LNR classification should be considered as a complementary system to TNM staging and LNR classification based clinical trials deserve further research.

Original languageEnglish (US)
Pages (from-to)3425-3434
Number of pages10
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume276
Issue number12
DOIs
StatePublished - Dec 1 2019

Fingerprint

Salivary Gland Neoplasms
Neoplasm Staging
Lymph Nodes
Proportional Hazards Models
Survival
Disease-Free Survival
Neoplasms
Epidemiology
Multivariate Analysis
Clinical Trials
Databases

Keywords

  • Lymph node ratio
  • Prognosis
  • Radiotherapy
  • Salivary gland cancer
  • TNM staging

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Lymph node ratio (LNR) as a complementary staging system to TNM staging in salivary gland cancer. / Lei, Bo Wen; Hu, Jia Qian; Yu, Peng Cheng; Wang, Yu Long; Wei, Wen Jun; Zhu, Ji; Shi, Xiao; Qu, Ning; Lu, Zhong Wu; Ji, Qing Hai.

In: European Archives of Oto-Rhino-Laryngology, Vol. 276, No. 12, 01.12.2019, p. 3425-3434.

Research output: Contribution to journalArticle

Lei, Bo Wen ; Hu, Jia Qian ; Yu, Peng Cheng ; Wang, Yu Long ; Wei, Wen Jun ; Zhu, Ji ; Shi, Xiao ; Qu, Ning ; Lu, Zhong Wu ; Ji, Qing Hai. / Lymph node ratio (LNR) as a complementary staging system to TNM staging in salivary gland cancer. In: European Archives of Oto-Rhino-Laryngology. 2019 ; Vol. 276, No. 12. pp. 3425-3434.
@article{06f0101fb8854b2cb59b214b87523124,
title = "Lymph node ratio (LNR) as a complementary staging system to TNM staging in salivary gland cancer",
abstract = "Purpose: The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of multiple human malignancies has been reported. We aim to evaluate its value in salivary gland cancer (SGC). Methods: Records of SGC patients from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 4262) and Fudan University Shanghai Cancer Center (FUSCC, validating set, N = 154) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile. Results: Optimal LNR cutoff points classified patients into four risk groups, R0, R1 (≤ 0.17), R2 (0.17–0.56) and R3 (> 0.56), corresponding to 5-year cause-specific survival in SEER patients of 88.6{\%}, 57.2{\%}, 53.1{\%} and 39.7{\%}, disease-free survival in FUSCC patients of 69.2{\%}, 63.3{\%}, 34.6{\%} and 0{\%}, and disease-specific survival in FUSCC patients of 92.3{\%}, 90.0{\%}, 71.4{\%} and 0{\%}, respectively. Compared with TNM staging, TNM + R staging showed smaller AIC values and higher C-index values in the Cox regression model in both patient sets. Conclusions: LNR classification should be considered as a complementary system to TNM staging and LNR classification based clinical trials deserve further research.",
keywords = "Lymph node ratio, Prognosis, Radiotherapy, Salivary gland cancer, TNM staging",
author = "Lei, {Bo Wen} and Hu, {Jia Qian} and Yu, {Peng Cheng} and Wang, {Yu Long} and Wei, {Wen Jun} and Ji Zhu and Xiao Shi and Ning Qu and Lu, {Zhong Wu} and Ji, {Qing Hai}",
year = "2019",
month = "12",
day = "1",
doi = "10.1007/s00405-019-05597-0",
language = "English (US)",
volume = "276",
pages = "3425--3434",
journal = "European Archives of Oto-Rhino-Laryngology",
issn = "0937-4477",
publisher = "Springer Verlag",
number = "12",

}

TY - JOUR

T1 - Lymph node ratio (LNR) as a complementary staging system to TNM staging in salivary gland cancer

AU - Lei, Bo Wen

AU - Hu, Jia Qian

AU - Yu, Peng Cheng

AU - Wang, Yu Long

AU - Wei, Wen Jun

AU - Zhu, Ji

AU - Shi, Xiao

AU - Qu, Ning

AU - Lu, Zhong Wu

AU - Ji, Qing Hai

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Purpose: The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of multiple human malignancies has been reported. We aim to evaluate its value in salivary gland cancer (SGC). Methods: Records of SGC patients from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 4262) and Fudan University Shanghai Cancer Center (FUSCC, validating set, N = 154) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile. Results: Optimal LNR cutoff points classified patients into four risk groups, R0, R1 (≤ 0.17), R2 (0.17–0.56) and R3 (> 0.56), corresponding to 5-year cause-specific survival in SEER patients of 88.6%, 57.2%, 53.1% and 39.7%, disease-free survival in FUSCC patients of 69.2%, 63.3%, 34.6% and 0%, and disease-specific survival in FUSCC patients of 92.3%, 90.0%, 71.4% and 0%, respectively. Compared with TNM staging, TNM + R staging showed smaller AIC values and higher C-index values in the Cox regression model in both patient sets. Conclusions: LNR classification should be considered as a complementary system to TNM staging and LNR classification based clinical trials deserve further research.

AB - Purpose: The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of multiple human malignancies has been reported. We aim to evaluate its value in salivary gland cancer (SGC). Methods: Records of SGC patients from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 4262) and Fudan University Shanghai Cancer Center (FUSCC, validating set, N = 154) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile. Results: Optimal LNR cutoff points classified patients into four risk groups, R0, R1 (≤ 0.17), R2 (0.17–0.56) and R3 (> 0.56), corresponding to 5-year cause-specific survival in SEER patients of 88.6%, 57.2%, 53.1% and 39.7%, disease-free survival in FUSCC patients of 69.2%, 63.3%, 34.6% and 0%, and disease-specific survival in FUSCC patients of 92.3%, 90.0%, 71.4% and 0%, respectively. Compared with TNM staging, TNM + R staging showed smaller AIC values and higher C-index values in the Cox regression model in both patient sets. Conclusions: LNR classification should be considered as a complementary system to TNM staging and LNR classification based clinical trials deserve further research.

KW - Lymph node ratio

KW - Prognosis

KW - Radiotherapy

KW - Salivary gland cancer

KW - TNM staging

UR - http://www.scopus.com/inward/record.url?scp=85073981994&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073981994&partnerID=8YFLogxK

U2 - 10.1007/s00405-019-05597-0

DO - 10.1007/s00405-019-05597-0

M3 - Article

C2 - 31511971

AN - SCOPUS:85073981994

VL - 276

SP - 3425

EP - 3434

JO - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

IS - 12

ER -