title: Prognostic significance of nodal ratio in cutaneous squamous cell carcinoma of the head and neck.
abstract: The TNM classification is not specific for head and neck skin cancer and makes no allowance for disease extent. Studies have shown that the relative number of metastatic-to-examined lymph nodes, termed the Nodal ratio, is a reliable independent prognosticator in several types of cancer. The study was designed as a retrospective analysis in a university affiliated tertiary care center setting. The files of all patients (n = 71) with cutaneous head and neck squamous cell carcinoma and regional lymph node metastasis who attended a tertiary medical center between 1990 and 2008 were reviewed for clinical variables and outcome, and Nodal ratio was calculated. Data were analyzed for impact on survival. On multivariate analysis Nodal ratio and age were found to be significant predictors of overall survival. The N-ratio was the only significant predictor of disease-specific survival. Age, type of treatment (selective/modified neck dissection), pathologic N stage, and radiotherapy had no effect. The Nodal ratio is a potentially valuable prognostic index in cutaneous squamous cell carcinoma. The minimal number of nodes that need to be excised has to be determined.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, 49100 Petach Tikva, Israel. avirammi@bezeqint.net
authors.forename: Aviram
authors.initials: A
authors.lastname: Mizrachi
authors.forename: Tuvia
authors.initials: T
authors.lastname: Hadar
authors.forename: Naomi
authors.initials: N
authors.lastname: Rabinovics
authors.forename: Thomas
authors.initials: T
authors.lastname: Shpitzer
authors.forename: Dan
authors.initials: D
authors.lastname: Guttman
authors.forename: Raphael
authors.initials: R
authors.lastname: Feinmesser
authors.forename: Gideon
authors.initials: G
authors.lastname: Bachar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate