Prognostic value of lymph node ratio for locoregional failure in patients with advanced head and neck cancers.

Abstract In the current study, the utility of lymph node ratio (LNR) was evaluated as an alternative method for predicting locoregional failure in patients with advanced head and neck cancer. Fifty-six patients with oral and (pharyngo)laryngeal squamous cell carcinoma were included. Among those, 48 were males and 8 females, with a mean age of 58 years. The primary tumor was located in the oral cavity in 16 cases, involved the larynx in 17 cases and the hypopharynx in 23 cases. All the tumors were staged T4. We carried out 112 neck dissections. All the lymph nodes harvested from the neck dissection were carefully examined, with LNR calculated as the ratio of positive lymph nodes to total lymph nodes removed. All the patients received adjuvant (chemo)radiotherapy. Receiver operating characteristic curve analysis showed LNR was significantly associated with locoregional failure. LNR >0.09 (as the cutoff point) could predict locoregional failure after surgery for oral and (pharyngo)laryngeal cancers with a sensibility of 93% and specificity of 100%. After surgery, pathologic evaluation of the neck using LNR was found to reliably predict the risk of locoregional recurrence in patients with advanced head and neck cancers.