The prognostic value of lymph node ratio in survival of head-and-neck squamous cell carcinoma

Abstract

Background head-and-neck squamous cell carcinoma(HNSCC) is the sixth most prevalant type of cancers in the world. Due to its relaively high rate of recurrence, the Prognosis is poor and the several rate is low; therefore,identifing the prognostic factors is considered necessary for better treatment. Materials and Methods: This historical cohort study was conducted on 201 patients diagnised with aerodigestive SCC who underwent surgery and lymph node dissection. We determined the prognostic value of lymph node ratio(LNR) on overall survival(OS), desesae-free survival(DFS), and locoregional failure-free survival(LFFS). We noticed an association between LNR and kaplan-meter analysis. Hazard ratio(HR) of LNR was determined by cox's regression model.Result: Two hundred and one patient entered this study after their medical histories were evaluated.The mean of lymph node count and LNR was 14.30(+/- 9.50) and 0.12,(+/- 0.23),respectively.Either patients (39.80) experienced recurrence of SCC. Five-year OS,DFS,and LFFS were 32,21 and 64,respectively. the median of OS was 40.70 months and 30.11 months in patients with LNR of <= 0.06 and >0.06 respectively(p<0.01).the LNR >0.06 was found the significant prognostic factor for lower OS of patients with HNSCC (HR=2.111.10,4.40;P=0.04).DFS was not a significantly different among patients with LNR <= 0.06 and patients with LNR >0.06(P= 0.9).However,LFFS was slightly different among two groups (HR= 2.04 0.90-4.80; P < 0.1). ConclusionL: We recommend more intensive adjuvent terapies such as chemotherapy with radiotherapy and short interal follow-up for patients with LNR> 0.06. Further investigation with large sample size as recommended.