Lymph node ratio as a survival predictor for head and neck squamous cell carcinoma with multiple adverse pathological features

• Published in: Head & neck Vol. 45; no. 8; pp. 2017 - 2027
• Main Authors: Tsai, Ming‐Hsien, Chuang, Hui‐Ching, Chien, Chih‐Yen, Huang, Tai‐Lin, Lu, Hui, Su, Yan‐Ye, Yang, Chao‐Hui, Lai, Chi‐Chih, Tsai, Wen‐Ling, Lin, Yu‐Tsai, Fang, Fu‐Min
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.08.2023; Wiley Subscription Services, Inc
• Subjects: Carcinoma, Squamous Cell - pathology; Chemoradiotherapy; Chemotherapy; extranodal extension; Head & neck cancer; Head and neck carcinoma; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; head and neck squamous cell carcinoma; Humans; Lymph Node Ratio; Lymph nodes; Lymph Nodes - pathology; lymphovascular invasion; Neoplasm Staging; perineural invasion; Prognosis; Radiation therapy; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - therapy; Statistical analysis; perineural invasion; lymph node ratio; lymphovascular invasion; extranodal extension; head and neck squamous cell carcinoma
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27428

Background The study investigates the prognostic significance of lymph node ratio (LNR) on patients with head and neck squamous cell carcinoma (HNSCC) with coexistence of multiple adverse pathological features. Methods In total, 100 patients with coexistence of perineural invasion, lymphovascular invasion, and extranodal extension of first primary HNSCC treated with radical surgery followed by adjuvant chemoradiotherapy were enrolled. Results The optimal LNR cut‐off value for predicting overall survival (OS) and cancer specific survival (CSS) was 7%. In Cox model, we observed that LNR ≥7% was a statistically significant unfavorable predictor of OS (HR: 2.689; 95% CI: 1.228–5.889; p = 0.013) and CSS (HR: 3.162; 95% CI: 1.234–8.102; p = 0.016). Conclusion For HNSCC patients with coexistence of multiple adverse pathological features, LNR is an independent survival predictor. Novel intensified treatments are needed for the subgroup of patients with a high LNR.