Prognostic indicators for survival in head and neck squamous cell carcinomas: analysis of a series of 621 cases.
BACKGROUND
We sought to study the influence of pT classification, pN status, tumor volume, and number of lymph nodes invaded on survival of patients with head and neck cancers to improve therapeutic indications.


METHODS
This was a retrospective study of 621 consecutive patients treated from 1990 to 1997 by a single team.


RESULTS
In univariate analysis, pT classification (p < .0001), pN status (p < .0001), capsule rupture (p < .0001), the number of lymph nodes invaded (0, 1-3, 4-9, > or =10) (p < .0001), and the tumor volume (p < .0001) were significantly associated with overall survival. A Cox model identified as independent prognostic indicators age (p < .0001), pT classification (p < .0001), and pN status (p < .0001).


CONCLUSIONS
Not only pT classification and pN status but also the number of the lymph nodes invaded and the tumor volume should be considered as essential prognostic indicators, and any clinical trial developed should stratify accordingly.
Le Tourneau
Christophe
C
Service d'épidémiologie et de biostatistique, Centre Paul Strauss, 3, rue de la porte de l'hôpital, 67065 Strasbourg, France. clt1@tiscali.fr
Velten
Michel
M
Jung
Guy-Michel
GM
Bronner
Guy
G
Flesch
Henri
H
Borel
Christian
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis