Evidence map›Paper›PMID 42900200›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Quantitative pathological lymph node parameters in head and neck squamous cell carcinoma: a comprehensive analysis of complementary prognostic value in clinically relevant subgroups.

Cornelius H L Kürten, Valentin Funk, Sarah Theurer, Marc Ingenwerth, Vinithagowry Sivakumar, Elena Lazzarini, Sara Aksu, Thomas Gauler, Maja Guberina, Sylvia Hartmann and 5 more

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. 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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1 · What the graph read from it

What it found

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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.

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Cornelius H L KürtenDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany. cornelius.kuerten@uk-essen.de.ORCID http://orcid.org/0000-0002-2720-0075
Valentin FunkDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Sarah TheurerInstitute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Marc IngenwerthInstitute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Vinithagowry SivakumarDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Elena LazzariniDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Sara AksuDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Thomas GaulerDepartment of Radiation Oncology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Maja GuberinaDepartment of Radiation Oncology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Sylvia HartmannInstitute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Anke DaserDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Kerstin StährDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Stefan MattheisDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Stephan LangDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Timon HussainDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeQuantitative pathological lymph node parameters (qpLNP), i.e. lymph node yield (LNY), lymph node ratio (LNR), and weighted lymph node ratio (WLNR), are potential prognostic markers in head and neck squamous cell carcinoma (HNSCC). Incorporation into post-operative staging may help to direct more precise adjuvant treatment regimens. Available data warrant more detailed subgroup analyses, we therefore evaluated their prognostic value with particular attention to neck dissection laterality, pN0 disease, and patients without recommendation for adjuvant therapy.

methodsWe performed a retrospective analysis of 410 surgically treated HNSCC patients from a single tertiary center (2010-2020). Data-derived cutoffs were determined by recursive partitioning. Overall survival was analyzed using Kaplan-Meier estimates, log-rank tests, and multivariable Cox regression. 67 patients with HPV-associated oropharyngeal carcinoma were analyzed separately.

resultsIn 343 patients with HPV-unrelated HNSCC, LNY, LNR, and WLNR were independently associated with overall survival on multivariable analysis (LNY: HR 1.58, p=0.012; LNR: HR 1.77, p=0.026; WLNR: HR 2.30, p<0.001). Discriminative performance increased from LNY (C-index 0.55) to LNR (0.59) to WLNR (0.61). Prognostic signal was primarily driven by the ipsilateral and not the contralateral neck. LNY (HR 1.92, p=0.044) and WLNR (HR 2.31, p=0.038) showed prognostic value in patients without adjuvant therapy, and LNY remained independently prognostic in node-negative patients on multivariable analysis (HR 1.88, p=0.027). Site-specific analyses in patients with HPV-unrelated oropharyngeal carcinoma and oral cavity carcinoma treated with bilateral neck dissection confirmed independent prognostic value for LNY and WLNR in both subgroups. In HPV-associated oropharyngeal carcinoma, qpLNP held no prognostic value. Here, extranodal extension was the dominant prognostic factor.

conclusionLNY, LNR, and WLNR provide complementary prognostic information in HPV-unrelated HNSCC. The validity of LNY in node-negative patients emphasizes its value as a quality control parameter for surgery while WLNR's performance in patients without adjuvant therapy suggests additional value in patient stratification for adjuvant treatment.

Indexed as

HPVLymph node ratioLymph node yieldNeck dissectionPrognosisWeighted lymph node ratio

Identifiers

PMID42900200

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