Abstract
PurposeLymph node metastasis (LNM) has a negative impact on the survival of patients with laryngeal squamous cell carcinoma (LSCC). Supraglottic LSCC is the most common cause of cervical lymph node metastases due to the extensive submucosal lymphatic plexus. The accurate evaluation of LNM before surgery can inform improved decisions in the clinic. In this study, we aimed to construct a nomogram to predict LNM in primary supraglottic LSCC patients.MethodsThe data from 314 patients with clinico-pathological confirmed supraglottic LSCC who underwent partial or total laryngectomy in our department from 2016 to 2020 were retrospectively analyzed (243 cases in the training set and 71 cases in the validation set). A multivariate logistic regression model was used to screen out independent risk factors and a nomogram was established. The accuracy and discrimination ability of the nomogram was evaluated using a consistency index and calibration curves.ResultsTumor size, tumor differentiation degree and LMR (lymphocyte-monocyte ratio) were selected to construct the nomogram. The C-index was 0.731 in the training set and 0.707 in the validation set. The calibration curves of the training and validation group both exhibited close agreement between the predicted and the actual presence of LNM.ConclusionsA nomogram was established based on routinely measured pretreatment variables and the predicted results improved the management of patients with LNM.
Highlights
Laryngeal cancer (LC) is one of the most common tumors of the respiratory tract [1]
Nomogram for Lymph Node Metastasis inflammatory conditions whilst false negatives can be due to the small size of metastatic lymph nodes or cystic changes [5]
This study retrospectively collected 314 clinical cases of newly diagnosed primary supraglottic LSCC confirmed by postoperative pathology in the Eye, Ear, Nose, and Throat Hospital of Fudan University
Summary
Laryngeal cancer (LC) is one of the most common tumors of the respiratory tract [1]. LC can be anatomically subdivided into glottic, supraglottic, and subglottic cancer based on its primary site. 60-70% of cases originate from the glottis and approximately 35% of cases originate from the supraglottic site [2]. LC can be anatomically subdivided into glottic, supraglottic, and subglottic cancer based on its primary site. 60-70% of cases originate from the glottis and approximately 35% of cases originate from the supraglottic site [2]. The supraglottic area is characterized by a rich lymphatic network resulting in a high potential for the development of regional metastases [3]. The involvement of metastatic cervical lymph nodes has been shown to negatively impact survival [4]. Positive lymph nodes may be palpable or can be detected by ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). False positive results are frequently caused by Nomogram for Lymph Node Metastasis inflammatory conditions whilst false negatives can be due to the small size of metastatic lymph nodes or cystic changes [5]
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