title: Lymph node ratio as a prognostic factor in head and neck cancer patients.
abstract: BACKGROUND
  Lymph node status is one prognostic factor in head and neck cancer. The purpose of this study is to investigate the prognostic value of lymph node ratio (LNR) in head and neck cancer patients who received surgery plus postoperative chemoradiotherapy.
  
  
  METHODS
  From May 1991 to December 2012, a total of 117 head and neck cancer patients who received surgery plus postoperative chemoradiotherapy were analyzed. The primary sites were oral cavity (93), oropharynx (13), hypopharynx (6), and larynx (5). All patients had pathologically confirmed squamous cell carcinoma and 63 patients had neck lymph nodes metastasis. LNR was calculated for each patient. The endpoints were overall survival (OS), local failure-free survival (LFFS), and distant metastasis-free survival (DMFS).
  
  
  RESULTS
  The median follow up time was 36 months, with a range from 3.4 to 222 months. The 3-year rates of OS, LFFS, and DMFS were 59.7, 70.3, and 81.8%, respectively. The median value of LNR for lymph nodes positive patients was 0.1. In univariate analysis, patients with an LNR value less than 0.1 had better 3-year OS (67.0% vs.41.0%, p = 0.004), 3-year LFFS (76.1% vs. 54.9%, p = 0.015) and 3-year DMFS (87.2% vs. 66.4%, p = 0.06). Multivariate analysis revealed that LNR was an independent prognostic factor for OS (hazard ratio [HR] = 2.92; 95% confidence interval [CI] = 1.367-6.242; p = 0.006) and LFFS (HR = 4.12; 95% CI = 1.604-10.59; p = 0.003).
  
  
  CONCLUSIONS
  LNR is an important prognosis factor for OS and LFFS in head and neck cancer patients.
authors: Department of Radiation Oncology, Taichung Veterans General Hospital, No.1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan, Republic of China. chiencheh@gmail.com.
authors: Chien-Chih
authors: CC
authors: Chen
authors: Department of Radiation Oncology, Taichung Veterans General Hospital, No.1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan, Republic of China. jclin@vghtc.gov.tw.|Department of Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan, Republic of China. jclin@vghtc.gov.tw.
authors: Jin-Ching
authors: JC
authors: Lin
authors: Department of Radiation Oncology, Taichung Veterans General Hospital, No.1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan, Republic of China. kwchen@vghtc.gov.tw.
authors: Kuan-Wen
authors: KW
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D059248:Chemoradiotherapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck