Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer

Yafeng Pan,1 Xuye Zhao,2 Dean Zhao,1 Junhua Liu1 1Department of Otolaryngology, Xiang’an Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China; 2Department of Breast and Thyroid Surgery, Xiang’an Hospital of Xiamen University, Xiamen, Fujian, People&...

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Autores principales:	Pan Y, Zhao X, Zhao D, Liu J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	elderly t3-t4 laryngeal cancer lymph node dissection survival nomogram Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/51334a26a78f49fe8ef3a6bc814d411d
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spelling	oai:doaj.org-article:51334a26a78f49fe8ef3a6bc814d411d2021-12-02T16:09:04ZLymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer1178-1998https://doaj.org/article/51334a26a78f49fe8ef3a6bc814d411d2020-12-01T00:00:00Zhttps://www.dovepress.com/lymph-nodes-dissection-in-elderly-patients-with-t3-t4-laryngeal-cancer-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yafeng Pan,1 Xuye Zhao,2 Dean Zhao,1 Junhua Liu1 1Department of Otolaryngology, Xiang’an Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China; 2Department of Breast and Thyroid Surgery, Xiang’an Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of ChinaCorrespondence: Junhua LiuDepartment of Otolaryngology, Xiang’an Hospital of Xiamen University, Xiamen, Fujian 361101, People’s Republic of ChinaEmail xaherbihou@163.comObjective: To explore the survival value of lymph node dissection (LND) in elderly patients with T3-T4 laryngeal cancer, analyze the risk factors of lymph node metastasis, and construct a preoperative prediction model.Materials and Methods: The study included 996 patients aged ≥ 65 years with laryngectomy confirmed T3-T4 laryngeal cancer queried from Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2017. Propensity score matching (PSM) was applied to balance the effects of confounding factors. Kaplan–Meier (K–M) analysis and competitive risk model were used to compare the overall survival (OS) and cancer-specific survival (CSS) between LND and no-LND (N-LND) group. Combined with risk factors of multivariate logistic regression, a nomogram was built to predict lymph node metastasis preoperatively. The performance was assessed in the training set and the validation set, and internal validation was assessed.Results: Among the cohort, 822 patients underwent LND and 410 patients had positive lymph nodes. The OS and CSS of patients who underwent LND were not better than that of N-LND patients (P> 0.05). The prognosis of patients with lymph node metastases was significantly worse than that of negative patients (P< 0.05). On multivariate logistic regression, supraglottis cancer, tumor size > 5cm and grade 3– 4 classification were associated with significantly greater odds of lymph node metastasis. The nomogram showed favorable predictive efficacy and good calibration (in the training cohort C-index=0.700; in the validation cohort C-index=0.721).Conclusion: For elderly patients with T3-T4 laryngeal cancer, LND did not bring significant survival values. Supraglottis cancer, tumor size > 5cm and grade 3– 4 classification were independent risk factors of lymph node metastasis, which means poor prognosis. The nomogram developed was an easy-to-use tool for lymph node prediction.Keywords: elderly, T3-T4 laryngeal cancer, lymph node dissection, survival, nomogramPan YZhao XZhao DLiu JDove Medical Pressarticleelderlyt3-t4 laryngeal cancerlymph node dissectionsurvivalnomogramGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 2321-2330 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	elderly t3-t4 laryngeal cancer lymph node dissection survival nomogram Geriatrics RC952-954.6
spellingShingle	elderly t3-t4 laryngeal cancer lymph node dissection survival nomogram Geriatrics RC952-954.6 Pan Y Zhao X Zhao D Liu J Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer
description	Yafeng Pan,1 Xuye Zhao,2 Dean Zhao,1 Junhua Liu1 1Department of Otolaryngology, Xiang’an Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China; 2Department of Breast and Thyroid Surgery, Xiang’an Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of ChinaCorrespondence: Junhua LiuDepartment of Otolaryngology, Xiang’an Hospital of Xiamen University, Xiamen, Fujian 361101, People’s Republic of ChinaEmail xaherbihou@163.comObjective: To explore the survival value of lymph node dissection (LND) in elderly patients with T3-T4 laryngeal cancer, analyze the risk factors of lymph node metastasis, and construct a preoperative prediction model.Materials and Methods: The study included 996 patients aged ≥ 65 years with laryngectomy confirmed T3-T4 laryngeal cancer queried from Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2017. Propensity score matching (PSM) was applied to balance the effects of confounding factors. Kaplan–Meier (K–M) analysis and competitive risk model were used to compare the overall survival (OS) and cancer-specific survival (CSS) between LND and no-LND (N-LND) group. Combined with risk factors of multivariate logistic regression, a nomogram was built to predict lymph node metastasis preoperatively. The performance was assessed in the training set and the validation set, and internal validation was assessed.Results: Among the cohort, 822 patients underwent LND and 410 patients had positive lymph nodes. The OS and CSS of patients who underwent LND were not better than that of N-LND patients (P> 0.05). The prognosis of patients with lymph node metastases was significantly worse than that of negative patients (P< 0.05). On multivariate logistic regression, supraglottis cancer, tumor size > 5cm and grade 3– 4 classification were associated with significantly greater odds of lymph node metastasis. The nomogram showed favorable predictive efficacy and good calibration (in the training cohort C-index=0.700; in the validation cohort C-index=0.721).Conclusion: For elderly patients with T3-T4 laryngeal cancer, LND did not bring significant survival values. Supraglottis cancer, tumor size > 5cm and grade 3– 4 classification were independent risk factors of lymph node metastasis, which means poor prognosis. The nomogram developed was an easy-to-use tool for lymph node prediction.Keywords: elderly, T3-T4 laryngeal cancer, lymph node dissection, survival, nomogram
format	article
author	Pan Y Zhao X Zhao D Liu J
author_facet	Pan Y Zhao X Zhao D Liu J
author_sort	Pan Y
title	Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer
title_short	Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer
title_full	Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer
title_fullStr	Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer
title_full_unstemmed	Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer
title_sort	lymph nodes dissection in elderly patients with t3-t4 laryngeal cancer
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/51334a26a78f49fe8ef3a6bc814d411d
work_keys_str_mv	AT pany lymphnodesdissectioninelderlypatientswitht3t4laryngealcancer AT zhaox lymphnodesdissectioninelderlypatientswitht3t4laryngealcancer AT zhaod lymphnodesdissectioninelderlypatientswitht3t4laryngealcancer AT liuj lymphnodesdissectioninelderlypatientswitht3t4laryngealcancer
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Lymph Nodes Dissection in Elderly Patients with T3-T4 Laryngeal Cancer

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