Evidence map›Paper›PMID 33987347›Full record

ArticleAnnals of translational medicine2021

Risk stratification and corresponding postoperative treatment strategies for occult contralateral lymph node metastasis in pyriform sinus squamous cell carcinoma patients with ipsilateral node-positive necks.

Yu Heng, Xiaoke Zhu, Liang Zhou, Ming Zhang, Kenan Li, Lei Tao

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Article in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors at 1 institution in 1 country.

Yu HengENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Xiaoke ZhuENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Liang ZhouENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Ming ZhangENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Kenan LiENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Lei TaoENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Eye & ENT Hospital of Fudan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo quantitatively predict the probability of occult contralateral lymph node metastasis (cLNM) for pyriform sinus squamous cell carcinoma (PSSC) patients with ipsilateral node-positive necks to guide postoperative adjuvant treatment.

methodsTwo hundred and twenty-seven PSSC patients with ipsilateral lymph node metastasis (iLNM) were retrospectively analyzed.

resultsMultivariate logistic analyses showed that five factors including maximum tumor diameter (MTD) of more than 4.0 cm, existence of tumor extension across the midline (EAM), internal jugular vein adhesion (IJVA), lymphovascular invasion (LVI), and lymph nodal fusion (LNF) were independent risk factors for cLNM. A predictive nomogram was created based on these factors. The accuracy and validity of our model were verified by concordance index (C-index) 0.862 [95% confidence interval (CI): 0.810-0.914] in development cohort and 0.860 (95% CI: 0.820-0.900) after 1,000 bootstrapping. The calibration curve also showed a relatively favorable agreement. We then stratified patients into three groups based on their cLNM risk scores. Possible cLNM rates for low-risk, moderate-risk, and relatively high-risk subgroups were 3.6%, 21.8%, and 60.7%, respectively.

conclusionsA new postoperative adjuvant radiotherapy (PART) strategy selection flow chart was created for PSSC patients based on our newly built nomogram which can effectively predict the individualized possibility of cLNM. For patients in high-risk subgroup, therapeutic-dose PART is highly recommended even for those with contralateral clinical N0 neck disease. For those in moderate-risk subgroup, prophylactic-dose PART is recommended. However, for patients in low-risk subgroup, regular follow-up is sufficient given the extremely low occult cLNM rate.

Indexed as

occult contralateral lymph node metastasis (occult cLNM)postoperative adjuvant radiotherapy (PART)Pyriform sinus squamous cell carcinoma (PSSC)risk prediction modeltreatment choice

Identifiers

PMID33987347
PMCPMC8106010
OpenAlexW3136913323

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