title: Lymph Node Density in Node-Positive Laryngeal Carcinoma: Analysis of Prognostic Value for Survival.
abstract: We investigated the value of lymph node density (LND) as a predictor of survival in patients with laryngeal squamous cell carcinoma (SCC) and positive neck node (pN+) after laryngectomy.
  
  
  
  Case series with chart review.
  
  
  
  Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
  
  
  
  We reviewed the records of 289 patients with newly diagnosed primary laryngeal carcinomas who underwent partial or total laryngectomy and combined neck dissection at a tertiary referral center between June 2006 and December 2014. Patients with pN+ laryngeal SCC (n = 101) were included in the study. Overall survival (OS) and disease-free survival (DFS) were used to evaluate the prognostic significance of LND.
  
  
  
  In 101 patients with pN+ laryngeal SCC, LND ≥0.09 and number of metastatic lymph nodes >4 were significantly associated with OS and DFS but not the overall tumor, node, and metastasis stage. Forward stepwise Cox regression analysis revealed that LND ≥0.09 was the only independent predictor of both DFS and OS. Furthermore, the odds ratio of LND ≥0.09 was 10 times higher in patients with regional recurrence when compared patients without regional recurrence.
  
  
  
  LND was the only independent prognostic predictor of OS and DFS in patients with pN+ laryngeal SCC. Moreover, patients with LND ≥0.09 were significantly associated with high risk of regional recurrence. Thus, patients with LND ≥0.09 are at high risk of regional recurrence and death and may be considered for adjuvant chemoradiation.
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey kadir_imre@yahoo.com.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Imre
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Pinar
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Dincer
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Ozkul
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Hale
authors.initials: H
authors.lastname: Aslan
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Songu
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Tatar
authors.affiliation: Department of Pathology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Irem
authors.initials: I
authors.lastname: Onur
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Ozturkcan
authors.affiliation: Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aladag
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology
keywords: disease free survival; laryngeal carcinoma; lymph node density; lymph node metastasis; overall survival; prognostic factors