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

Head Neck. 2023 Aug;45(8):2017-2027. doi: 10.1002/hed.27428. Epub 2023 Jun 9.

Abstract

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.

Keywords: extranodal extension; head and neck squamous cell carcinoma; lymph node ratio; lymphovascular invasion; perineural invasion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Lymph Node Ratio
  • Lymph Nodes / pathology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / therapy