Prognostischer Wert von Lymphknotenmerkmalen beim (Trans)glottischen Kehlkopfkarzinom: eine Retrospektive Studie

Introduction
The surgical management of the neck in laryngeal carcinoma is still under debate. The extent of lymph node removal as well as the nodal involvement have an effect on survival in head and neck cancer patients, but specific data on laryngeal carcinoma is missing. This study assesses the prognostic value of lymph node features on overall survival in glottic and transglottic laryngeal carcinoma.

Methods
This is a retrospective analysis of 53 patients that have undergone primary surgery (laryngectomy and neck dissection) for glottic or transglottic laryngeal carcinoma between January 2010 and January 2024 in a tertiary care center. The main dependent variables are nodal yield (NY = the number of excised lymph nodes), lymph node burden (LNB = number of positive lymph nodes), lymph node ratio (LNR = LNB/NY) and the log odds of positive lymph nodes (LODDS = log ((LNB + 0.5) / (NY-LNB + 0.5)). Multivariate survival analysis was performed in R using the maxstat package and an optimized algorithm to determine cutoff values was used.

Results
The mean NY per patient was 55,7 ± 28,3 and 43% of patients showed positive nodes. The mean values for the variables of interest were 1,07±1,69 (LNB), 0,03± 0,11 (LNR), and 0,05 ± 0,5 (LODDS) respectively. A LNB < 2 was independently associated with increased overall survival (Hazard Ratio (HR): 0,24, p < 0,05), as was a LNR <0,04 (HR: 0,19, p < 0,05) and a LODDS <0,29 (HR: 0,19, p < 0,05).

Discussion
LNB, LNR and LODDS are predictors of overall survival in the case of (trans)glottic laryngeal carcinoma. If validated by further data, these variables might help decide on adjuvant therapy.

References:

1. doi:10.1007/s00405-021-07176-8

2. doi:10.1007/s00432-020-03352-1

3. doi:10.1007/s00405-016-3928-2

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