Nodal ratio as an independent predictor of survival in squamous cell carcinoma of the oral cavity.
BACKGROUND
The association between nodal ratio and survival in oral cavity carcinomas has recently been proposed, but no prospective evaluations exist.


METHODS
We sought to determine, using an institutional database, whether nodal ratio impacts survival in node-positive oral cavity squamous cell carcinoma.


RESULTS
Between 1994 and 2004, 143 new diagnoses of N(1-2) squamous cell carcinoma of the oral cavity were identified. The mean number of nodes identified was 41.6, and the mean nodal ratio was 9%. Nodal ratio was strongly statistically associated with overall and disease-specific survival in both univariate and multivariate analyses. No other prognostic indicator maintained that degree of statistical significance. Patients could be stratified into low (0% to 6%), moderate (6% to 13%), and high-risk (>13%) groups based on nodal ratio.


CONCLUSIONS
In squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified by nodal ratio.
Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Mark G
MG
Shrime
Gideon
G
Bachar
Jane
J
Lea
Cheryl
C
Volling
Clement
C
Ma
Patrick J
PJ
Gullane
Ralph W
RW
Gilbert
Jonathan C
JC
Irish
Dale H
DH
Brown
David P
DP
Goldstein
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult