Lymph node ratio as an independent prognostic factor in oral squamous cell carcinoma

Background We aimed to validate the lymph node ratio (LNR) as an independent prognostic factor in oral squamous cell carcinoma (OSCC) and compare its utility with the current nodal staging system. Methods We conducted a retrospective analysis of 313 patients with OSCC undergoing neck dissection. The LNR was adjusted by relevant covariates in a multivariable Cox regression model. Results LNR displaced conventional nodal staging and was shown to be an independent predictor of regional failure (p =.020), disease-specific (p =.003) and overall survival (p =.001). Patients with an LNR of 2.5% to 7.5%, 7.5% to 20%, and >20% had 2.6, 3.7, and 4.4 times the risk of death from OSCC, respectively, when compared with patients with an LNR <2.5%. Conclusions The LNR is an independent prognostic factor in OSCC and may be used in conjunction with the current TNM staging to enable better risk stratification and selection for adjuvant therapy. © 2010 Wiley Periodicals, Inc. Head Neck, 2010