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- Title
Predicting Pathologic Lymph Node Positivity in cN0 Pharynx and Larynx Cancers.
- Authors
Anderson, Eric M.; Luu, Michael; Lu, Diana J.; Chung, Eric M.; Gay, Christopher; Scher, Kevin S.; Mita, Alain C.; Mallen‐St. Clair, Jon; Ho, Allen S.; Zumsteg, Zachary S.
- Abstract
Background: Elective neck dissection is a standard of care for pharynx and most larynx cancer patients undergoing surgery, based largely on historical series. It is unclear if this is necessary for all patients in the modern era. Methods: Patients with cN0 oropharynx, larynx, and hypopharynx cancers diagnosed from 2010–2015 undergoing primary surgery were identified in the National Cancer Data Base. Results: Inclusion criteria were met by 4117 cN0 patients. The presence of lymphovascular invasion (LVI) was the strongest independent predictor of pN+ (odds ratio [OR] = 4.19, 95% confidence interval [CI] 3.56–4.93, p < 0.001). Histologic grade strongly predicted pN+ (OR 2.58, 95% CI 1.88–3.59, p < 0.001). A nomogram predicted less than 10% of cN0 patients had pN+ risk <15%. Conclusion: LVI and grade are the strongest predictors of pN+ among patients with cN0 pharynx and larynx cancer. Even in the modern era, pN+ rates warrant neck dissection for cN0 patients. Level of Evidence: 3 Laryngoscope, 133:1660–1666, 2023
- Subjects
PHARYNGEAL cancer; LARYNGEAL cancer; LYMPH nodes; HYPOPHARYNGEAL cancer; LARYNGECTOMY; CANCER patients
- Publication
Laryngoscope, 2023, Vol 133, Issue 7, p1660
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.30358