{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:30:51Z","timestamp":1747150251760,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Elective neck dissection is a standard of care for pharynx and most larynx cancer patients undergoing surgery, based largely on historical series. It is unclear if this is necessary for all patients in the modern era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with cN0 oropharynx, larynx, and hypopharynx cancers diagnosed from 2010\u20132015 undergoing primary surgery were identified in the National Cancer Data Base.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Inclusion criteria were met by 4117 cN0 patients. The presence of lymphovascular invasion (LVI) was the strongest independent predictor of pN+ (odds ratio [OR]\u00a0=\u00a04.19, 95% confidence interval [CI] 3.56\u20134.93, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Histologic grade strongly predicted pN+ (OR 2.58, 95% CI 1.88\u20133.59, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). A nomogram predicted less than 10% of cN0 patients had pN+ risk &lt;15%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LVI and grade are the strongest predictors of pN+ among patients with cN0 pharynx and larynx cancer. Even in the modern era, pN+ rates warrant neck dissection for cN0 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 133:1660\u20131666, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30358","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T10:32:32Z","timestamp":1661250752000},"page":"1660-1666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predicting Pathologic Lymph Node Positivity in <scp>cN0<\/scp> Pharynx and Larynx Cancers"],"prefix":"10.1002","volume":"133","author":[{"given":"Eric M.","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Luu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana J.","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric M.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Gay","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin S.","family":"Scher","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Department of Medical Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Tower Hematology Oncology  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain C.","family":"Mita","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Department of Medical Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Mallen\u2010St. Clair","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5423-509X","authenticated-orcid":false,"given":"Allen S.","family":"Ho","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7484-3631","authenticated-orcid":false,"given":"Zachary S.","family":"Zumsteg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."},{"name":"Samuel Oschin Comprehensive Cancer Institute Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880120302"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1990.01870040054013"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197206)29:6<1446::AID-CNCR2820290604>3.0.CO;2-C"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.10.018"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80554-9"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0901-5027(97)80837-5"},{"key":"e_1_2_5_8_1","first-page":"543","article-title":"Prospective feasibility trial of radiotherapy target definition for head and neck cancer using 3\u2010dimensional PET and CT imaging","volume":"45","author":"Scarfone C","year":"2004","journal-title":"J Nucl Med"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199710000-00004"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-19425-7"},{"key":"e_1_2_5_12_1","first-page":"211","article-title":"Clinicopathological predictors of lymphatic metastasis in HNSCC: implications for molecular mechanisms of metastatic disease","volume":"8","author":"Goldson TM","year":"2010","journal-title":"J Exp Ther Oncol"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506007"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01661"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.8777"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21622"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21001"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01182"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30358","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.30358","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30358","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T19:59:42Z","timestamp":1692561582000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30358"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":17,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1002\/lary.30358"],"URL":"https:\/\/doi.org\/10.1002\/lary.30358","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2022,8,23]]},"assertion":[{"value":"2021-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}