Factors Associated with Lymph Node Count in Mucosal Squamous Cell Carcinoma Neck Dissection.
Age Factors
Aged
Aged, 80 and over
Body Mass Index
Deglutition Disorders
/ epidemiology
Female
Head and Neck Neoplasms
/ complications
Humans
Lymph Nodes
/ immunology
Male
Malnutrition
/ epidemiology
Middle Aged
Neck Dissection
/ statistics & numerical data
Neoplasm Staging
Prognosis
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Squamous Cell Carcinoma of Head and Neck
/ complications
Head and neck squamous cell carcinoma
body mass index
extracapsular extension
immunocompromised
lymph node count
neck dissection
nodal yield
p16 +
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
02
11
2020
received:
12
09
2020
accepted:
11
12
2020
pubmed:
5
1
2021
medline:
25
6
2021
entrez:
4
1
2021
Statut:
ppublish
Résumé
Decreased lymph node count (LNC) from neck dissection (ND) for mucosal head and neck squamous cell carcinoma (HNSCC) patients is correlated with decreased survival. Advanced age and low BMI due to undernutrition from dysphagia from advanced T-stage tumors are common in patients with HNSCC. We studied the relationship between these two well-described causes for immune dysfunction and LNC in patients undergoing neck dissection. We conducted a retrospective review at a single tertiary care institution of patients with HNSCC that underwent neck dissection from 2006 to 2017. Stepwise linear and logistic regression analyses were performed on 247 subjects to identify independent significant factors associated with 1) the LNC per neck level dissected; 2) advanced T-stage. One-way ANOVA was utilized to demonstrate differences between the p16 positive and negative subgroups. Low BMI (<23 vs. ≥23) (P = .03), extra nodal extension (ENE) (P = .0178), and advanced age (P = .005) were associated with decreased LNC per neck level dissected on multivariable analysis. Higher T-stage (P = .0005) was correlated with low BMI (<23) after controlling for the effects of tobacco, smoking, sex, ECE, and p16 status. p16+ patients, on average had higher BMI, were younger and produced a higher nodal yield (P < .0001, .007, and .035). Patient intrinsic factors known to correlate with decreased immune function and worse outcomes, including p16 negative status, advanced age, and low BMI from undernutrition and ENE are associated with low nodal yield in neck dissections. LNC may be a metric for anti-tumor immune function that correlates with prognosis and T-stage. 3 Laryngoscope, 131:1516-1521, 2021.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1516-1521Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001105
Pays : United States
Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
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