title: Lymph node density as an independent prognostic factor in node-positive patients with tonsillar cancer.
abstract: The purpose of this study was to evaluate the utility of lymph node density for predicting the survival of patients with tonsillar cancer and positive neck nodes.
  
  
  
  We reviewed data for 64 patients diagnosed with tonsillar cancer with lymph node metastasis in a retrospective single center audit.
  
  
  
  Lymph node density (≥0.05), extracapsular spread (ECS), number of ECS (≥3), vascular invasion, perineural invasion, and N classification (N1/N2a vs N2b/N2c) were significant predictors of 5-year disease-free survival (DFS). Lymph node density (≥0.05), human papillomavirus (HPV) infection, and N classification (N1/N2a vs N2b/N2c) were significant predictors of 5-year overall survival (OS). In the multivariate analysis, categorical lymph node density remained a significant predictor of DFS (p = .025*; hazard ratio [HR] = 6.063) and no parameter was significantly predictive of OS.
  
  
  
  Lymph node density might be useful as an independent predictor of survival in patients with tonsillar cancer and positive lymph nodes. © 2015 Wiley Periodicals, Inc. Head Neck 38: E705-E711, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea.
authors.forename: Jun-Ook
authors.initials: JO
authors.lastname: Park
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, South Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Joo
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, South Korea.
authors.forename: Kwang-Jae
authors.initials: KJ
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, South Korea.
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D027383:Papillomaviridae; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000175:diagnosis*
keywords: head and neck; lymph node density; neck dissection; squamous cell carcinoma; survival; tonsillar neoplasm