Impact of nodal ratio on survival in squamous cell carcinoma of the oral cavity

Head Neck. 2009 Sep;31(9):1129-36. doi: 10.1002/hed.21073.


Background: The association between nodal ratio and survival has not been assessed in squamous cell carcinomas of the head and neck.

Methods: This is a population-based analysis, using the Surveillance, Epidemiology, and End-Results database, to determine whether nodal ratio impacts survival in patients with oral cavity squamous cell carcinoma.

Results: Between 1988 and 2005, 2955 new diagnoses of N(1) or N(2) squamous cell carcinoma of the oral cavity were identified. The mean nodal ratio was 16.9%. Nodal ratio was found to be strongly statistically associated with overall survival in both univariate and multivariate analyses. Patients could be stratified into low- (0% to 6%), moderate- (6% to 12.5%), and high-risk (>12.5%) groups based on nodal ratio.

Conclusions: In patients with squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified based on nodal ratio.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality*
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / therapy
  • Neck Dissection
  • Prognosis
  • Proportional Hazards Models
  • Survival Analysis
  • Survival Rate
  • Young Adult