Anatomic extent of lymph node metastases as an independent prognosticator in node-positive major salivary gland carcinoma: A study of the US SEER database and a Chinese multicenter cohort

医学 队列 淋巴结 肿瘤科 内科学 唾液腺 队列研究 节点(物理) 多中心研究 数据库 病理 计算机科学 结构工程 工程类 随机对照试验
作者
Xiao Shi,Xuekui Liu,Chang-Ming An,Wen‐Jun Wei,Yungan Tao,Yuan Ji,Yan Zhang,Wei Han,Jin-Cai Xue,Nai-Si Huang,Ben Ma,Chen-ping Zhang,Xi Yang,Ke-Jing Wang,Qin-Jiang Liu,Yang Liu,Yu Wang,Bo-Wen Lei,Peng-Cheng Yu,Jia-Qian Hu,Zhong-wu Lu,Wenjun Wei,You-Xin Tian,Yulong Wang,Qinghai Ji
出处
期刊:Ejso [Elsevier BV]
卷期号:45 (11): 2143-2150 被引量:4
标识
DOI:10.1016/j.ejso.2019.06.029
摘要

Background We aimed to explore whether the anatomic extent of lymph node metastases (AE-LNM) could independently predict prognosis of node-positive major salivary gland carcinoma (MaSGC). Methods A total of 376 pathologically node-positive MaSGC patients were identified from the Surveillance, Epidemiology and End Results database and constituted the training cohort. Using the X-Tile program, these patients were divided into three groups based on AE-LNM degrees. Discrimination of overall survival (OS) and disease-specific survival (DSS) was evaluated and compared with the 8th American Joint Committee on Cancer (AJCC) pN classification. The results were externally validated by 220 patients in a Chinese multicenter cohort (Validation cohort). Results Using the training cohort, AE-LNM was divided into Extent 1 (spread to parotid LNs or level I), Extent 2 (spread to level II-IV) and Extent 3 (spread to level V or bilateral LNs or rare LNs). Regarding both OS and DSS, the AE-LNM model revealed clear separation of survival curves, while the pN classification failed to discriminate the prognosis of pN1 and pN2 patients. When we incorporated both the AE-LNM model and AJCC pN classification into the same multivariate Cox analyses, AE-LNM was still an independent prognostic factor, while the AJCC pN classification lost its significance. These results were externally validated by the validation cohort. Conclusion AE-LNM is an independent nodal prognosticator for node-positive MaSGC and may have improved discriminative ability over the current AJCC pN classification. Integration of anatomic extent of LNM into the current AJCC N classification could be considered.
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