Evidence map›Paper›PMID 41104839›Full record

ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2025

Lymph Nodal Yield and Prediction of Mortality in Oral Squamous Cell Carcinoma Patients.

Christian Mirian, Lasse Rehné Jensen, Mathias Hald, Davide Mattavelli, Cesare Piazza, Linda Feeley, Patrick Sheahan, Marcel Oehme, Christian Freudlsperger, Julius Moratin and 1 more

Abstract readMulticenter Study
In one paragraph

Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Christian MirianDepartment of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, Herning, Denmark.ORCID https://orcid.org/0000-0001-6801-0123
Lasse Rehné JensenDepartment of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, Herning, Denmark.ORCID https://orcid.org/0000-0001-6931-4399
Mathias HaldDepartment of Otorhinolaryngology, Aarhus University Hospital, Aarhus, Denmark.
Davide MattavelliUnit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy.ORCID https://orcid.org/0000-0001-7023-6746
Cesare PiazzaUnit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy.
Linda FeeleyDepartment of Pathology, Cork University Hospital, Cork, Ireland.ORCID https://orcid.org/0000-0002-7521-8253
Patrick SheahanENTO Research Unit, College of Medicine and Health, University College Cork, Cork, Ireland.
Marcel OehmeDepartment of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Christian FreudlspergerDepartment of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Julius MoratinDepartment of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.ORCID https://orcid.org/0000-0002-0278-7228
Therese OvesenDepartment of Otorhinolaryngology, Head and Neck Surgery, Gødstrup Hospital, Herning, Denmark.ORCID https://orcid.org/0000-0003-0864-7987

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLymph nodal yield (LNY) is increasingly used in oral squamous cell carcinoma (OSCC) research as a prognostic factor and quality metric but remain to be validated across independent OSCC cohorts. STUDY

designRetrospective cohort study.

settingPrimary OSCC patients (n = 1080) who underwent a neck dissection, collected from three sites: Brescia, Cork, and Heidelberg.

methodsThe accuracy of LNY in predicting 3- and 5-year mortality was evaluated using the area under the ROC curve (AUC). Binomial regression models, adjusted for LNY and various confounders, were used to cross-validate predictive performance across independent cohorts. A model estimating the population-average treatment effect of LNY was used to estimate the effect of what would have been observed if the OSCC patients had been randomly assigned to have specific ranges of LNYs removed, irrespective of their individual characteristics. Mean LNY was estimated between the three cohorts.

resultsROC curve analysis demonstrated that LNY did not improve prognostic accuracy in predicting 3- and 5-year mortality risks. Cross-validation across independent cohorts showed that adding LNY to the binomial regression models did not improve predictive accuracy. Using the LNY range of 33 to 44 as a reference, the average treatment effect model found no significant difference in the 3-year risk of death across LNY groups (LNY: 2-17, 17-25, 25-33, and 44-119) for pN-positive patients.

conclusionWe found no improvement in the prognostic accuracy for mortality when considering LNY in different settings. Substantial inter-center variability and lack of consistent survival benefit challenge the use of LNY as a prognostic or surgical quality metric.

Indexed as

Carcinoma, Squamous CellLymph NodesMouth NeoplasmsAdultAgedFemaleHumansLymphatic MetastasisLymph Node ExcisionMaleMiddle AgedNeck DissectionPrognosisRetrospective StudiesROC CurveSurvival Ratehead and neckLNYlymph nodal yieldoral squamous cell carcinomaOSCCsurvival

Identifiers

PMID41104839
PMCPMC12661473

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.