title: Impact of nodal ratio on survival in squamous cell carcinoma of the oral cavity.
abstract: BACKGROUND
  The association between nodal ratio and survival has not been assessed in squamous cell carcinomas of the head and neck.
  
  
  METHODS
  This is a population-based analysis, using the Surveillance, Epidemiology, and End-Results database, to determine whether nodal ratio impacts survival in patients with oral cavity squamous cell carcinoma.
  
  
  RESULTS
  Between 1988 and 2005, 2955 new diagnoses of N(1) or N(2) squamous cell carcinoma of the oral cavity were identified. The mean nodal ratio was 16.9%. Nodal ratio was found to be strongly statistically associated with overall survival in both univariate and multivariate analyses. Patients could be stratified into low- (0% to 6%), moderate- (6% to 12.5%), and high-risk (>12.5%) groups based on nodal ratio.
  
  
  CONCLUSIONS
  In patients with squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified based on nodal ratio.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, University of Toronto, Toronto, Ontario. shrime@alumni.princeton.edu
authors.forename: Mark G
authors.initials: MG
authors.lastname: Shrime
authors.forename: Clement
authors.initials: C
authors.lastname: Ma
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gullane
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Gilbert
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Irish
authors.forename: Dale H
authors.initials: DH
authors.lastname: Brown
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein