Lymph node ratio as a prognostic marker of oral tongue squamous cell carcinoma: A cohort study
Community Health Sciences; General Surgery; Otolaryngology, Head and Neck Surgery
Introduction: Lymph node metastasis is a poor prognostic indicator and is well established in tongue squamous cell carcinoma. Based on the current staging system, accurate risk stratification is difficult. There is thus a need to evaluate an alternate method for predicting recurrence and survival. The objective of the study was to evaluate lymph node ratio as a prognostic marker as compared with N-staging for tongue squamous cell carcinoma.
Materials and methods: We conducted a retrospective cohort study with 56 patients with a lymph node ratio greater than 0.012 (exposed) and 74 patients with a lymph node ratio less than 0.012 (unexposed). Overall five-year survival and disease-free survival were assessed. The Cox proportional hazard model was used to analyse lymph node ratio as a predictor of outcome, together with other covariates.
Results: A total of 130 patients were included in the study. Patients with lymph node ratio greater than 0.012 had a poor overall five-year (mean survival time 52.1 months vs 38.1 months) and disease-free survival (mean survival time 53.6 months vs 39.2 months). The hazard of death among patients with a lymph node ratio greater than 0.012 was 3.24 times higher than the hazard of death among patients with a lymph node ratio less than 0.012 (95% confidence interval 1.82-5.77).
Discussion: Lymph node ratio is a superior prognostic marker compared with the currently used American Joint Committee on Cancer N-staging. Our findings also suggest that the margin status (involved) of the primary tumour resection adversely affects prognosis.
Annals of the Royal College of Surgeons of England
Nathani, K. R.
(2020). Lymph node ratio as a prognostic marker of oral tongue squamous cell carcinoma: A cohort study. Annals of the Royal College of Surgeons of England, 1-7.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_otolaryngol_head_neck/121