Erschienen in:
01.04.2009 | Head and Neck Oncology
In Reply
verfasst von:
Maya D. Leggett, MD, Steve R. Martinez, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 4/2009
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Excerpt
Dr. Metze is to be commended for his efforts at explaining a possible mechanism whereby lymph node yield (LNY) may be mistakenly identified as a significant prognostic factor at more advanced N stages.
1 The basis for his theory lies in the introduction of bias inherent to pathological analysis (sampling bias). If numerous macroscopic (and likely metastatic) lymph nodes are detectable on cursory examination, Dr. Metze asserts, then why go looking for smaller lymph nodes that are less likely to be involved with metastases? Such bias may artificially increase the significance of LNY as the number of lymph nodes with metastases approaches the total number of lymph nodes excised. Dr. Metze has utilized a test dataset to illustrate his point. In his analysis, if the pathologist fails to remove even a few “negative” lymph nodes, LNY fails to reach statistical significance on univariate analysis. …