title: Which is the most suitable lymph node predictor for overall survival after primary surgery of head and neck cancer: pN, the number or the ratio of positive lymph nodes, or log odds?
abstract: OBJECTIVE
  To investigate the best lymph node (LN) metastasis predictor for overall survival (OS) in head neck cancer (HNC): pN classification, number of positive lymph nodes (PNOD), lymph node ratio (LNR), or log odds of positive lymph nodes (LODDS).
  
  
  METHODS
  In total, 225 surgically treated HNC patients were evaluated for the different LN classifications and OS.
  
  
  RESULTS
  Five-year OS was 71.8 %. Mean number of yielded LN and PNOD was 25.3 ± 16.7 and 2.7 ± 5.9, respectively. 64.8 % had a LNR > 0.10 and 64.4 % a LODDS > 10. In univariable analysis, multimodal therapy (p = 0.039), advanced pT (p < 0.0001), advanced UICC stage (p = 0.029), LNR > 0.10 (p = 0.049), and LODDS > -1.0 (p = 0.021) were associated with lower OS. In multivariable analysis, advanced pT [hazard ratio (HR) 2.194; 95 % confidence interval (CI) 1.294-3.722; p = 0.004] and LODDS > -1.0 (HR 1.634; 95 % CI 1.002-2.665; p = 0.059) remained independent predictors for lower OS.
  
  
  CONCLUSIONS
  It seems useful to analyze the prognostic significance of LODDS in other samples of HNC.
authors.affiliation: Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany.
authors.forename: Mehmet Metin
authors.initials: MM
authors.lastname: Yildiz
authors.affiliation: Institute of Pathology, Jena University Hospital, Jena, Germany.
authors.forename: Iver
authors.initials: I
authors.lastname: Petersen
authors.affiliation: University Tumor Center, Jena University Hospital, Jena, Germany.
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Eigendorff
authors.affiliation: Department of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Schlattmann
authors.affiliation: Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany. orlando.guntinas@med.uni-jena.de.
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
mesh_terms: D000328:Adult; D000368:Aged; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D005260:Female; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012042:Registries
keywords: Cancer staging; Head and neck neoplasm; Lymph nodes; Lymphatic metastasis; Neck dissection; Survival