Examined and positive lymph nodes counts and lymph nodes ratio are associated with survival in major salivary gland cancer

Head Neck. 2019 Aug;41(8):2625-2635. doi: 10.1002/hed.25742. Epub 2019 Mar 23.


Background: We aimed to investigate the prognostic role of examined (dissected) lymph nodes (ELNs), negative LNs (NLNs), and positive (metastatic) LNs (PLNs) counts and LN ratio (LNR = PLNs/ELNs×100) in patients with major salivary gland cancer (SGC).

Methods: Data were retrieved for major SGC patients diagnosed between 1988 and 2011 from Surveillance, Epidemiology, and End Results program.

Results: We have included 5446 patients with major SGC. Most patients had parotid gland cancer (84.61%). Patients having >18 ELNs, >4 PLNs, and >33.33% LNR were associated with a worse survival. Moreover, older age, male patients, grade IV, distant stage, unmarried patients, submandibular gland cancer, and received chemotherapy but not received surgery were significantly associated with a worse survival.

Conclusions: We demonstrated that patients with >18 ELNs and >4 PLNs counts, and >33.33% LNR were high-risk group patients. We strongly suggest adding the ELNs and PLNs counts and/or LNR into the current staging system.

Keywords: SEER; lymph node; metastasis; ratio; salivary gland; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis*
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Prognosis
  • Proportional Hazards Models
  • Salivary Gland Neoplasms / mortality
  • Salivary Gland Neoplasms / pathology*