The Effect of Extranodal Extension on Survival in Laryngeal Carcinoma
- Larinks karsinomu olan hastalarda lenf nodu metastazı ve özellikle ekstranodal yayılım (ENE), sağkalım oranlarını önemli ölçüde düşüren kritik bir negatif prognostik faktördür.
- Yapılan çalışma, hastaları lenf nodu durumuna göre üç gruba ayırarak ekstranodal yayılımın uzun vadeli prognoz üzerindeki etkisini klinik verilerle analiz etmiştir.
- İstatistiksel sonuçlar, ekstranodal yayılımı olan hastaların genel ve 2 yıllık sağkalım oranlarının, sadece reaktif lenf nodu olan hastalara kıyasla anlamlı derecede düşük olduğunu göstermektedir.
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[H2 BAŞLIK]: The Significance of Lymph Node Metastasis in Laryngeal Carcinoma Survival
It is well-established in oncology that lymph node metastasis significantly reduces survival rates in patients diagnosed with laryngeal carcinoma. This retrospective study specifically investigates how extranodal extension (ENE) within these metastases influences long-term prognosis. By analyzing clinical data, the research aims to clarify the prognostic weight of ENE in patients undergoing surgical intervention for advanced stages of the disease.
[H2 BAŞLIK]: Methodology and Patient Classification
The study reviewed the demographic characteristics and histopathologic results of 81 patients who underwent total laryngectomy and neck dissection between 2011 and 2018. The patient population, with a mean age of 61.56 years, consisted of 75 males and 6 females. To ensure a precise survival analysis, the participants were categorized into three distinct groups based on their lymph node status:
- Group 1: Patients with reactive lymph nodes.
- Group 2: Patients with lymph node metastasis but no detected extranodal extension.
- Group 3: Patients with lymph node metastasis and confirmed extranodal extension.
[H2 BAŞLIK]: Comparative Survival Analysis and Results
The research focused on both Overall Survival (OS) and 2-year Overall Survival rates across the three groups. The findings indicate a progressive decline in survival as the severity of nodal involvement increases. The statistical data highlights a significant difference between those with reactive nodes and those with extranodal extension.
[H3 BAŞLIK]: Survival Rate Comparison Table
| Patient Group | Overall Survival (OS) | 2-Year OS Rate |
|---|---|---|
| Group 1 (Reactive) | 81% | 66.7% |
| Group 2 (Metastasis without ENE) | 69.2% | 46.2% |
| Group 3 (Metastasis with ENE) | 61.5% | 38.5% |
[H2 BAŞLIK]: Statistical Significance and Clinical Conclusion
Statistical analysis revealed a clear distinction between Group 1 and Group 3 regarding both OS (P = .014) and 2-year OS (P = .008). While the survival rates decreased in Group 2, no statistically significant difference was found when comparing Group 2 to Group 1 or Group 3.
In conclusion, the detection of neck lymphadenopathy metastasis and extranodal extension serves as a critical negative prognostic factor. For patients undergoing total laryngectomy and neck dissection due to advanced laryngeal carcinoma, the presence of ENE is directly associated with lower survival outcomes.
