{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:07:40Z","timestamp":1790813260163,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Prognostic lymph node yield thresholds have been identified and incorporated into treatment guidelines for multiple cancer sites, but not for oral cancer. The objective of this study was to identify optimal thresholds in elective and therapeutic neck dissection for oral cavity cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with oral cavity cancers in the National Cancer Database (NCDB) were stratified into clinically lymph node\u2010negative (cN0) and clinically lymph node\u2010positive (cN+) cohorts to reflect the differing surgical management for these diseases. Univariate and multivariate analyses were performed to assess the relation between lymph node yield and overall survival, adjusting for other prognostic factors. Thresholds derived from the NCDB were validated in the Surveillance, Epidemiology, and End Results database.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In patients with cN0 cancers of the oral cavity from the NCDB, those who had &lt;16 lymph nodes had significantly decreased survival. The proportion of positive lymph nodes was higher for patients who had \u226516 lymph nodes (27.2% vs 16.3% for\u2009&lt;\u200916 lymph nodes; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). This threshold was validated in 2715 lymph node\u2010negative cancers from SEER, with a mortality hazard ratio of 0.825 for\u2009\u2265\u200916 lymph nodes (95% confidence interval, 0.764\u20100.950; <jats:italic>P<\/jats:italic>\u2009=\u2009.004). In patients with cN\u2009+\u2009oral cavity cancers from the NCDB, groups with &lt;26 lymph nodes had significantly decreased survival. This threshold was validated in 1903 lymph node\u2010positive cancers from SEER, with a mortality hazard ratio of 0.791 (95% confidence interval, 0.692\u20100.903; <jats:italic>P<\/jats:italic>\u2009=\u2009.001). Academic centers, higher volume centers, and geographic location predicted higher lymph node yields.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>More extensive neck dissection (\u226516 lymph nodes in cN0,\u2009\u2265\u200926 lymph nodes in cN+) was associated with better survival. Further evaluation of practice patterns in lymph node yield may represent an opportunity for improved quality of care. <jats:bold><jats:italic>Cancer<\/jats:italic> 2016;122:3624\u201031.<\/jats:bold> \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30227","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T14:04:55Z","timestamp":1470146695000},"page":"3624-3631","source":"Crossref","is-referenced-by-count":71,"title":["Proposing prognostic thresholds for lymph node yield in clinically lymph node\u2010negative and lymph node\u2010positive cancers of the oral cavity"],"prefix":"10.1002","volume":"122","author":[{"given":"Phoebe","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Surgery Otolaryngology, Yale School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saral","family":"Mehra","sequence":"additional","affiliation":[{"name":"Department of Surgery Otolaryngology, Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Center New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Sosa","sequence":"additional","affiliation":[{"name":"Department of Surgery Endocrine Surgery, Duke University School of Medicine Durham North Carolina"},{"name":"Duke Clinical Research Institute Durham North Carolina"},{"name":"Duke Cancer Institute Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanziana A.","family":"Roman","sequence":"additional","affiliation":[{"name":"Department of Surgery Endocrine Surgery, Duke University School of Medicine Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain A.","family":"Husain","sequence":"additional","affiliation":[{"name":"Yale Cancer Center New Haven Connecticut"},{"name":"Department of Therapeutic Radiology Yale School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Burtness","sequence":"additional","affiliation":[{"name":"Yale Cancer Center New Haven Connecticut"},{"name":"Department of Medicine Yale School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet P.","family":"Tate","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Veterans Affairs Connecticut Healthcare System West Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendell G.","family":"Yarbrough","sequence":"additional","affiliation":[{"name":"Department of Surgery Otolaryngology, Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Center New Haven 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