Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma

Kartik Vasan; Tsu-Hui (Hubert) Low; Ruta Gupta; Bruce Ashford; Rebecca Asher; Kan Gao; Sydney Ch'ng; Carsten E. Palme; Jonathan R. Clark

doi:10.1002/hed.25066

Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma

Kartik Vasan^*, Tsu-Hui (Hubert) Low, Ruta Gupta, Bruce Ashford, Rebecca Asher, Kan Gao, Sydney Ch'ng, Carsten E. Palme, Jonathan R. Clark

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

28 Citations (Scopus)

Abstract

Background: The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC. Methods: A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold. Results: Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P =.01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis. Conclusion: The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.

Original language	English
Pages (from-to)	993-999
Number of pages	7
Journal	Head and Neck
Volume	40
Issue number	5
DOIs	https://doi.org/10.1002/hed.25066
Publication status	Published - 1 May 2018
Externally published	Yes

Keywords

cutaneous squamous cell carcinoma
head and neck
lymph node ratio
prognostic
staging

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10.1002/hed.25066

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@article{e57399609715498ba26708d1240c2e60,

title = "Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma",

abstract = "Background: The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC. Methods: A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold. Results: Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P =.01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis. Conclusion: The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.",

keywords = "cutaneous squamous cell carcinoma, head and neck, lymph node ratio, prognostic, staging",

author = "Kartik Vasan and Low, {Tsu-Hui (Hubert)} and Ruta Gupta and Bruce Ashford and Rebecca Asher and Kan Gao and Sydney Ch'ng and Palme, {Carsten E.} and Clark, {Jonathan R.}",

year = "2018",

month = may,

day = "1",

doi = "10.1002/hed.25066",

language = "English",

volume = "40",

pages = "993--999",

journal = "Head and Neck",

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TY - JOUR

T1 - Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma

AU - Vasan, Kartik

AU - Low, Tsu-Hui (Hubert)

AU - Gupta, Ruta

AU - Ashford, Bruce

AU - Asher, Rebecca

AU - Gao, Kan

AU - Ch'ng, Sydney

AU - Palme, Carsten E.

AU - Clark, Jonathan R.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background: The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC. Methods: A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold. Results: Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P =.01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis. Conclusion: The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.

AB - Background: The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC. Methods: A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The minimal-P approach was used to investigate the optimal lymph node ratio threshold. Results: Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11-2.38; P =.01) and OS (HR 1.63; 95% CI 1.03-2.58; P = 0.04) on multivariable analysis. Conclusion: The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio >6% is a significant threshold to categorize patients into low and high risk.

KW - cutaneous squamous cell carcinoma

KW - head and neck

KW - lymph node ratio

KW - prognostic

KW - staging

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U2 - 10.1002/hed.25066

DO - 10.1002/hed.25066

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C2 - 29360276

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SN - 1043-3074

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JO - Head and Neck

JF - Head and Neck

IS - 5

ER -

Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma

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