Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma?
ABSTRACT Objective: To evaluate the influence of lymph node reactivity on recurrence and survival rates in a population of pT3 or pT4 pN0 patients with laryngeal squamous cell carcinoma. Methods: Between 2002 and 2005, 105 patients with LSSC underwent total laryngectomy with bilateral selective ne...
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100068&lng=en&tlng=en |
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| author | Gabriel Manfro Claudio Cernea Paulo Antônio Silvestre de Faria Fernando Vaz Agarez Fernando Luiz Dias Roberto Araújo Lima Lenine Garcia Brandão |
| author_facet | Gabriel Manfro Claudio Cernea Paulo Antônio Silvestre de Faria Fernando Vaz Agarez Fernando Luiz Dias Roberto Araújo Lima Lenine Garcia Brandão |
| author_sort | Gabriel Manfro |
| collection | DOAJ |
| description | ABSTRACT Objective: To evaluate the influence of lymph node reactivity on recurrence and survival rates in a population of pT3 or pT4 pN0 patients with laryngeal squamous cell carcinoma. Methods: Between 2002 and 2005, 105 patients with LSSC underwent total laryngectomy with bilateral selective neck dissection including levels II, III and IV. Most (69) received PO radiotherapy. All pathological specimens were either pT3 or pT4, and all necks were pN0. All lymph nodes were analyzed and their reactivity status were classified as the following four patterns: follicular hyperplasia associated with humoral response, paracortical hyperplasia associated with cellular response, sinus histiocytosis with no association with specific immune response, or normal lymph node. Only the first two patterns were considered stimulated, whereas the last two were considered non-stimulated. The most prevalent pattern in a particular neck specimen was considered for the analysis of recurrence and survival. Results: The total number of lymph nodes studied was 3,648, with an average of 34.7 lymph nodes/neck specimens. The most frequent lymph node reactivity patterns were sinusal histiocytosis (50 cases), paracortical hyperplasia (35 cases), and follicular hyperplasia (20 cases). There was no statistical association of these individual patterns with recurrence rate (p = 0.98) or mortality (p = 0.49). However, there was a statistically significant association between paracortical hyperplasia pattern (related to cellular lymph node immunity) and improved five-year survival (76 versus 60%; log-rank = 0.05). Conclusions: There was a positive correlation between stimulated cellular lymph node pattern and improved 5-year survival rate in patients with pN0 laryngeal squamous cell carcinoma, suggesting the indication of adjuvant treatment for those individuals with decreased immune response, even in the absence of pathologic metastases detected by the usual methods. |
| first_indexed | 2024-04-13T14:51:18Z |
| format | Article |
| id | doaj.art-1c98bcd780304819b37065aa8ca423d2 |
| institution | Directory Open Access Journal |
| issn | 2317-6385 |
| language | English |
| last_indexed | 2024-04-13T14:51:18Z |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-1c98bcd780304819b37065aa8ca423d22022-12-22T02:42:35ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-638581687410.1590/s1679-45082010ao1429S1679-45082010000100068Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma?Gabriel ManfroClaudio CerneaPaulo Antônio Silvestre de FariaFernando Vaz AgarezFernando Luiz DiasRoberto Araújo LimaLenine Garcia BrandãoABSTRACT Objective: To evaluate the influence of lymph node reactivity on recurrence and survival rates in a population of pT3 or pT4 pN0 patients with laryngeal squamous cell carcinoma. Methods: Between 2002 and 2005, 105 patients with LSSC underwent total laryngectomy with bilateral selective neck dissection including levels II, III and IV. Most (69) received PO radiotherapy. All pathological specimens were either pT3 or pT4, and all necks were pN0. All lymph nodes were analyzed and their reactivity status were classified as the following four patterns: follicular hyperplasia associated with humoral response, paracortical hyperplasia associated with cellular response, sinus histiocytosis with no association with specific immune response, or normal lymph node. Only the first two patterns were considered stimulated, whereas the last two were considered non-stimulated. The most prevalent pattern in a particular neck specimen was considered for the analysis of recurrence and survival. Results: The total number of lymph nodes studied was 3,648, with an average of 34.7 lymph nodes/neck specimens. The most frequent lymph node reactivity patterns were sinusal histiocytosis (50 cases), paracortical hyperplasia (35 cases), and follicular hyperplasia (20 cases). There was no statistical association of these individual patterns with recurrence rate (p = 0.98) or mortality (p = 0.49). However, there was a statistically significant association between paracortical hyperplasia pattern (related to cellular lymph node immunity) and improved five-year survival (76 versus 60%; log-rank = 0.05). Conclusions: There was a positive correlation between stimulated cellular lymph node pattern and improved 5-year survival rate in patients with pN0 laryngeal squamous cell carcinoma, suggesting the indication of adjuvant treatment for those individuals with decreased immune response, even in the absence of pathologic metastases detected by the usual methods.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100068&lng=en&tlng=enNeoplasias de cabeça e pescoçoCarcinoma de células escamosasNeoplasias laríngeas/imunologiaExcisão de linfonodoExcisão de linfonodo/efeitos adversosExcisão de linfonodo/mortalidadeRecidiva local de neoplasiaEsvaziamento cervical |
| spellingShingle | Gabriel Manfro Claudio Cernea Paulo Antônio Silvestre de Faria Fernando Vaz Agarez Fernando Luiz Dias Roberto Araújo Lima Lenine Garcia Brandão Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma? Einstein (São Paulo) Neoplasias de cabeça e pescoço Carcinoma de células escamosas Neoplasias laríngeas/imunologia Excisão de linfonodo Excisão de linfonodo/efeitos adversos Excisão de linfonodo/mortalidade Recidiva local de neoplasia Esvaziamento cervical |
| title | Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma? |
| title_full | Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma? |
| title_fullStr | Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma? |
| title_full_unstemmed | Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma? |
| title_short | Can the lymph node reactivity pattern in the pN0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma? |
| title_sort | can the lymph node reactivity pattern in the pn0 neck analysis provide any additional prognostic information in patients with laryngeal squamous cell carcinoma |
| topic | Neoplasias de cabeça e pescoço Carcinoma de células escamosas Neoplasias laríngeas/imunologia Excisão de linfonodo Excisão de linfonodo/efeitos adversos Excisão de linfonodo/mortalidade Recidiva local de neoplasia Esvaziamento cervical |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100068&lng=en&tlng=en |
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