Comparison of disease specific survival (DSS) among patients with different lymph node (LN) features.

A for 0 vs. 1 vs. 2 vs .3 vs. 4 vs. 5 vs. 6 vs. 7+; B for 0 vs. 1–2 vs. 3+; C for ratio of positive to total lymph nodes; D for AJCC N stage. AJCC, American Joint Committee on Cancer.</p

Comparison of overall survival (OS) among patients with different lymph node (LN) features.

A for 0 vs. 1 vs. 2 vs. 3 vs. 4 vs. 5 vs. 6 vs. 7+; B for 0 vs. 1–2 vs. 3+; C for ratio of positive to total lymph nodes; D for AJCC N stage. AJCC, American Joint Committee on Cancer.</p

Comparison of disease specific survival (DSS) among patients with different number of metastatic lymph nodes (LNs) stratificated by pathologic types.

A for adenoid cystic carcinoma (ACC), B for mucoepidermoid carcinoma (MEC), C for other types.</p

Flowchart of enrolled patients.

This study aimed to assess the impact of the number and ratio of metastatic lymph nodes (LNs) on prognosis in submandibular gland cancer. To this end, patients were selected from the Surveillance, Epidemiology, and End Results database retrospectively. The effect of the number and ratio of metastatic LNs and the American Joint Committee on Cancer (AJCC) N stage on disease-specific survival (DSS) and overall survival (OS) was analyzed. In addition, prognostic models based on LN evaluation methods were developed to predict the OS and DSS. A total of 914 patients were included. Binary recursive partitioning analysis determined the optimal cut-off number of metastatic LNs (0 vs. 1–2. vs. 3+). The presence of 3+ metastatic LNs carried the greatest impact on prognosis, followed by 1–2 positive LNs occurrences. The ratio of metastatic LNs was an independent factor for DSS and OS. The model had a higher likelihood ratio and C-index than those in the Cox model based on the AJCC N stage. Quantitative LN burden and ratio of metastatic LNs provides better survival stratification than the AJCC N stage.</div

Other independent variables in different models for disease specific survival and overall survival (OS).

Other independent variables in different models for disease specific survival and overall survival (OS).</p

Comparison of disease specific survival (DSS) among patients with different ratio of metastatic lymph nodes (LNs) stratificated by pathologic types.

A for adenoid cystic carcinoma (ACC), B for mucoepidermoid carcinoma (MEC), C for other types.</p

Comparison of overall survival (OS) among patients with different ratio of metastatic lymph nodes (LNs) stratificated by pathologic types.

A for adenoid cystic carcinoma (ACC), B for mucoepidermoid carcinoma (MEC), C for other types.</p

Independent impact of metastatic lymph nodes (LNs), ratio of positive to total LNs and the 8^th AJCC N stage on disease specific survival.

Independent impact of metastatic lymph nodes (LNs), ratio of positive to total LNs and the 8th AJCC N stage on disease specific survival.</p

Independent impact of metastatic lymph nodes (LNs), ratio of positive to total LNs and the 8^th AJCC N stage on overall survival.

Independent impact of metastatic lymph nodes (LNs), ratio of positive to total LNs and the 8th AJCC N stage on overall survival.</p

Univariate analysis of prognostic factors for disease specific survival (DSS) and overall survival (OS).

Univariate analysis of prognostic factors for disease specific survival (DSS) and overall survival (OS).</p