Predictive Value of Tumor Thickness for Cervical Lymph-Node Involvement in Squamous Cell Carcinoma of the Oral Cavity A Meta-analysis of Reported Studies-猫眼课题宝

DOI：

10.1002/cncr.24161

发表时间：

2009-04-01

期刊：

CANCER

影响因子：

6.2

通讯作者：

中科院分区：

医学1区

文献类型：

作者：

Huang, Shao Hui;Hwang, David;O'Sullivan, Brian

背景技术背景：肿瘤厚度（TT）似乎是口腔鳞状细胞癌（OSCC）颈部淋巴结受累的一个强有力的预测因子，但尚未建立一个精确的临床最佳TT临界点。为了解决这个问题，作者进行了荟萃分析。方法：从MEDLINE和EMBASE以及相关文章中引用的交叉引用出版物中识别所有相关文章。淋巴结转移被确认并通过即时颈淋巴清扫术的病理阳性或随访≥ 2年后的颈部复发确定为阳性淋巴结申报（PLND）。计算比值比（OR）以量化TT的预测价值。比较阴性预测值（以及错误预测为没有PLND的患者百分比[FN-PLND]），以确定最佳TT截止点。结果：从72项潜在的研究中选择了16项研究，总计1136例患者。检查了以下TT截止点的数据：3 mm（4项研究，387例患者）、4 mm（9项研究，778例患者）、5 mm（6项研究，367例患者）和6 mm（4项研究，488例患者）。总体组的OR（95% CI）为7.3（5.3-10.1）。TT组FN-PLND的比例分别为5.3%（95%CI，2.0-11.2）、4.5%（2.6-7.2）、16.6%（11.5-22.8）和13.0%（9.7-16.9

BACKGROUND: Tumor thickness (TT) appears to be a strong predictor for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity (OSCC), but a precise clinically optimal TT cutoff point has not been established. To address this question, the authors conducted a meta-analysis. METHODS: All relevant articles were identified from MEDLINE and EMBASE as well as from cross-referenced publications cited in relevant articles. Lymph-node involvement was confirmed and identified as positive lymph-node declaration (PLND) by either pathologic positivity on immediate neck dissection or by neck recurrence identified after follow-up >= 2 years, Odds ratios (OR) were calculated to quantify the predictive value of TT. Negative predictive values (and the percentage of patients falsely predicted to not have PLND [FN-PLND]) were compared to determine the optimal TT cutoff point. RESULTS: Sixteen studies were selected from 72 potential studies, yielding a pooled total of 1136 patients. Data were examined for the following TT cutoff points: 3 mm (4 studies, 387 patients), 4 mm (9 studies, 778 patients), 5 mm (6 studies, 367 patients), and 6 mm (4 studies, 488 patients), The OR (95% CI) was 7.3 (5.3-10.1) for the overall group. The proportion of FN-PLND was 5.3% (95% CI, 2.0-11.2), 4.5% (2.6-7.2), 16.6% (11.5-22.8), and 13.0% (9.7-16.9) for TT

Predictive Value of Tumor Thickness for Cervical Lymph-Node Involvement in Squamous Cell Carcinoma of the Oral Cavity A Meta-analysis of Reported Studies

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