{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:09:21Z","timestamp":1790813361562,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Lymph nodal yield (LNY) is increasingly used in oral squamous cell carcinoma (OSCC) research as a prognostic factor and quality metric but remain to be validated across independent OSCC cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary OSCC patients (n\u2009=\u20091080) who underwent a neck dissection, collected from three sites: Brescia, Cork, and Heidelberg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The accuracy of LNY in predicting 3\u2010 and 5\u2010year mortality was evaluated using the area under the ROC curve (AUC). Binomial regression models, adjusted for LNY and various confounders, were used to cross\u2010validate predictive performance across independent cohorts. A model estimating the population\u2010average treatment effect of LNY was used to estimate the effect of what\n                      <jats:italic>would have been<\/jats:italic>\n                      observed if the OSCC patients\n                      <jats:italic>had been<\/jats:italic>\n                      randomly assigned to have specific ranges of LNYs removed, irrespective of their individual characteristics. Mean LNY was estimated between the three cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ROC curve analysis demonstrated that LNY did not improve prognostic accuracy in predicting 3\u2010 and 5\u2010year mortality risks. Cross\u2010validation across independent cohorts showed that adding LNY to the binomial regression models did not improve predictive accuracy. Using the LNY range of 33 to 44 as a reference, the average treatment effect model found no significant difference in the 3\u2010year risk of death across LNY groups (LNY: 2\u201017, 17\u201025, 25\u201033, and 44\u2010119) for pN\u2010positive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found no improvement in the prognostic accuracy for mortality when considering LNY in different settings. Substantial inter\u2010center variability and lack of consistent survival benefit challenge the use of LNY as a prognostic or surgical quality metric.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70040","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T12:22:13Z","timestamp":1760703733000},"page":"1421-1431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lymph Nodal Yield and Prediction of Mortality in Oral Squamous Cell Carcinoma Patients"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-0123","authenticated-orcid":false,"given":"Christian","family":"Mirian","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery G\u00f8dstrup Hospital Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6931-4399","authenticated-orcid":false,"given":"Lasse Rehn\u00e9","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery G\u00f8dstrup Hospital Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Hald","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7023-6746","authenticated-orcid":false,"given":"Davide","family":"Mattavelli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology \u2010 Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia ASST Spedali Civili of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Piazza","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology \u2010 Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia ASST Spedali Civili of Brescia Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7521-8253","authenticated-orcid":false,"given":"Linda","family":"Feeley","sequence":"additional","affiliation":[{"name":"Department of Pathology Cork University Hospital Cork Ireland"},{"name":"ENTO Research Unit, College of Medicine and Health University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Sheahan","sequence":"additional","affiliation":[{"name":"ENTO Research Unit, College of Medicine and Health University College Cork Cork Ireland"},{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery, South Infirmary Victoria University Hospital Cork Ireland"},{"name":"Department of Surgery University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Oehme","sequence":"additional","affiliation":[{"name":"Department of Oral and Cranio\u2010Maxillofacial Surgery Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Freudlsperger","sequence":"additional","affiliation":[{"name":"Department of Oral and Cranio\u2010Maxillofacial Surgery Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0278-7228","authenticated-orcid":false,"given":"Julius","family":"Moratin","sequence":"additional","affiliation":[{"name":"Department of Oral and Cranio\u2010Maxillofacial Surgery Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0864-7987","authenticated-orcid":false,"given":"Therese","family":"Ovesen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery G\u00f8dstrup Hospital Herning Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus 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