title: Prediction of occult neck disease in laryngeal cancer by means of a logistic regression statistical model.
abstract: The ability to accurately predict the presence of subclinical metastatic neck disease in clinically N0 patients with primary epidermoid cancer of the larynx would be of great value in determining whether to perform an elective neck dissection. We describe a statistical approach to estimating the probability of occult neck disease given pretreatment clinical parameters. A retrospective study was performed involving 736 clinically N0 patients with primary laryngeal cancer who were treated surgically with primary resection and ipsilateral neck dissection. Nodal involvement was determined histologically after surgical lymphadenectomy. A logistic regression model was used to derive an equation that calculated the probability of occult neck metastasis based on pretreatment T stage, tumor location, and histologic grade. The model has a sensitivity of 74%, a specificity of 87%, and can be entered into a programmable calculator.
authors.affiliation: Department of Surgery, Veterans Administration Medical Center, Des Moines.
authors.forename: A F
authors.initials: AF
authors.lastname: Ghouri
authors.forename: R L
authors.initials: RL
authors.lastname: Zamora
authors.forename: D G
authors.initials: DG
authors.lastname: Sessions
authors.forename: E L
authors.initials: EL
authors.lastname: Spitznagel
authors.forename: J E
authors.initials: JE
authors.lastname: Harvey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000556:secondary*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011336:Probability; D011446:Prospective Studies; D012189:Retrospective Studies