Prognostic indicators for survival in head and neck squamous cell carcinomas: Analysis of a series of 621 cases

Background. We sought to study the influence of pT classification, pN status, tumor volume, and number of lymph nodes invaded on survival of patients with head and neck cancers to improve therapeutic indications. Methods. This was a retrospective study of 621 consecutive patients treated from 1990 to 1997 by a single team. Results. In univariate analysis, pT classification (p <.0001), pN status (p <.0001), capsule rupture (p <.0001), the number of lymph nodes invaded (0, 1-3, 4-9, >= 10) (p <.0001), and the tumor volume (p <.0001) were significantly associated with overall survival. A Cox model identified as independent prognostic indicators age (p <.0001), pT classification (p <.0001), and pN status (p <.0001). Conclusions. Not only pT classification and pN status but also the number of the lymph nodes invaded and the tumor volume should be considered as essential prognostic indicators, and any clinical trial developed should stratify accordingly. (c) 2005 Wiley Periodicals, Inc.