Hosni A, et al. – The impact of lymph node ratio (LNR, number of positive nodes/total number of excised nodes) on regional–only–failure, distant–only–failure and overall survival (OS) in oral squamous cell carcinoma (OSCC) was examined. This study depicted an association of high LNR with higher regional–only–failure/distant–only–failure and lower OS.

Methods

• Researchers presented a retrospective review of pN0-2 OSCC-patients (1994–2012) treated with curative-surgery with neck dissection±postoperative radiotherapy (PORT)±concurrent chemotherapy.
• A multivariable analysis (MVA) of regional-only-failure, distant-only-failure and OS was performed for LNR.

Results

• This study determined 914 patients.
• These subjects demonstrated median follow-up: 51 months (1–189); pN0: 482 (52.7%), pN1: 128 (14%), pN2a: 6 (0.7%); pN2b: 225 (24.6%); pN2c: 73 (8%); median number of dissected nodes: 36 (6–125); median number of pN+: 2 (1–49); median LNR for pN+ patients: 6%; extranodal extension: 187 (20.5%).
• Moreover, bilateral neck dissection: 368 (40.3%); PORT: 452 (49.5%); and concurrent chemotherapy: 80 (8.8%).
• An association of high grade, lymphovascular invasion perineural invasion and pT3–4 with high LNR, was noted.
• On MVA, an association of LNR with regional-only-failure (HR=1.06; 95%CI: 1.04–1.08; p<0.001), distant-only-failure (HR=1.03; 95%CI: 1.02–1.05; p=0.004) and lower OS (HR=1.03; 95%CI: 1.02–1.05; p<0.001), was observed.
• Similarly, in pN2-subgroup: a link was reported between LNR and regional-only-failure (HR=1.04; 95%CI: 1.02–1.06; p<0.001), distant-only-failure (HR=1.03; 95%CI: 1.01–1.06; p=0.045) as well as lower OS (HR=1.03; 95%CI: 1.02–1.04; p<0.001).