title: Multi-institutional investigation of the prognostic value of lymph nodel yield in advanced-stage oral cavity squamous cell carcinoma.
abstract: BACKGROUND
  Although existing literature provides surgical recommendations for treating occult disease (cN0) in early-stage oral cavity squamous cell carcinoma (SCC), a focus on late-stage oral cavity SCC is less pervasive.
  
  
  METHODS
  The medical records of 162 patients with late-stage oral cavity SCC pN0 who underwent primary neck dissections were reviewed. Lymph node yield as a prognosticator was examined.
  
  
  RESULTS
  Despite being staged pN0, patients that had a higher lymph node yield had an improved regional/distant control rates, disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Lymph node yield consistently outperformed all other standard variables as being the single best prognostic factor with a tight risk ratio range (RR = 0.95-0.98) even when correcting for the number of lymph nodes examined.
  
  
  CONCLUSIONS
  The results of this study showed that lower regional recurrence rates and improved survival outcomes were seen as lymph node yield increased for advanced T classification oral cavity SCC pN0. This suggests that increasing lymph node yield with an extended cervical lymphadenectomy may result in lower recurrence rates and improved survival outcomes for this advanced stage group.
authors.affiliation: Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, Chicago, Illinois.
authors.forename: James J
authors.initials: JJ
authors.lastname: Jaber
authors.forename: Chad A
authors.initials: CA
authors.lastname: Zender
authors.forename: Vikas
authors.initials: V
authors.lastname: Mehta
authors.forename: Kara
authors.initials: K
authors.lastname: Davis
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.forename: Pierre
authors.initials: P
authors.lastname: Lavertu
authors.forename: Rod
authors.initials: R
authors.lastname: Rezaee
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Feustel
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000517:prevention & control; D018572:Disease-Free Survival; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000517:prevention & control; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D055815:Young Adult
keywords: advanced stage; neck dissections; node negative; oral cavity squamous cell carcinoma; outcomes
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