Lymph Node Ratio Predictive of Survival in Node-Positive Head and Neck Cancer

Abstract

Purpose: Lymph node ratio (LNR) represents the ratio of positive lymph nodes to total excised lymph nodes. We analyzed the correlation between LNR and outcomes in patients who have undergone surgery for SCC of the head and neck. Materials and Methods: Thirty-three patients with head and neck squamous cell carcinoma (HNSCC) who underwent surgical resection and neck dissection were included. Kaplan-Meier analysis and log-rank test were used to compare differences in disease-free survival (DFS) and overall survival (OS). Results: In total, 28 males and 5 females with a median of age 57 years were identified, with a median recorded LNR of 0.1. The median DFS was 10.4 months, and the median OS was 32.5 months. When DFS and OS were compared by Kaplan-Meier survival analysis, we found that patients with the median LNR≥0.1 had significantly worse DFS (p:0.029) and OS (p:0.036) than patients with ratios below these threshold values. Considering other known predictors of recurrence and survival, we found that LNR was significantly associated with DFS (p=0.036, HR 0.38, 95% CI 0.15-0.93) and OS (p=0.042, HR 0.40, 95% CI 0.17-0.96). Conclusion: Our study showed that high LNR was an independent predictor of outcome in patients with HNSCC. In HNSCC, LNR can be used as an additional parameter to predict recurrence and survival.

Keywords

• head and neck cancer
• lymph node ratio
• recurrence
• survival