title: Risk stratification of oral cancer patients using a combined prognostic factor including lymph node density and biomarker.
abstract: OBJECTIVE
  In this study, we aimed to validate the lymph node density (LND) as an independent prognostic factor of oral squamous cell carcinoma (OSCC) and identify a combined prognostic factor including LND, predicting better performance in risk stratification.
  
  
  METHODS
  We reviewed the clinical, pathological variables and biomarker of 95 OSCC patients who underwent surgery. LND was calculated as the ratio of positive lymph nodes to total lymph nodes removed. Principle component analysis was performed to identify a combined predictor.
  
  
  RESULTS
  Multivariate analysis showed that variables independently prognostic overall survival were IMP3 (hazard ratio [HR] = 3.01, 95% confidence interval [95% CI] = 1.17-7.75, P = 0.022) in a model without LND and were IMP3 (HR = 3.64, 95% CI = 1.38-9.58, P = 0.008) and LND (HR = 0.57, 95% CI = 0.57-1.75, P = 0.322; HR = 2.45, 95% CI = 1.20-4.97, P = 0.013) in a model with LND. The risk stratification using the combined prognostic factor was more significant (P = 0.00117) than the conventional staging system and biomarker.
  
  
  CONCLUSIONS
  The LND was shown to be an independent prognostic factor in OSCC, and a combined factor including LND may be used for risk stratification of OSCC patients, which displayed the best performance.
authors.affiliation: Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul 120-752, Republic of Korea. kky1004@yuhs.ac
authors.forename: Ki-Yeol
authors.initials: KY
authors.lastname: Kim
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Cha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000737:chemistry* / Q000473:pathology*; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D016601:RNA-Binding Proteins / Q000032:analysis*; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; C498780:IGF2BP3 protein, human; D016601:RNA-Binding Proteins