Prognostic value of lymph node ratio in head and neck squamous cell carcinoma

Head Neck. 2018 May;40(5):1082-1090. doi: 10.1002/hed.25080. Epub 2018 Feb 2.


Background: Lymph node ratio (LNR) is increasingly reported as a potential prognostic tool. The purpose of this review was to analyze the available literature on the prognostic significance of LNR in head and neck squamous cell carcinoma (HNSCC).

Methods: A PubMed internet search was performed and articles meeting selection criteria were reviewed.

Results: Twenty-eight studies were identified in the literature dealing with the prognostic value of LNR. The published results are variable with a range of cutoff values of LNR associated with prognosis (overall survival [OS] and/or disease-specific survival [DSS]) between 0.02 and 0.20, with an average of 0.09.

Conclusion: The LNR is reported to be of value in assessing prognosis in the patients with HNSCC. Although it is easy to calculate and could be considered in the staging of these patients, the currently available evidence in the literature does not yet provide a solid base for implementation.

Keywords: head and neck squamous cell carcinoma; lymph node metastasis; lymph node ratio; neck dissection; prognosis.

Publication types

  • Review

MeSH terms

  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck / mortality
  • Squamous Cell Carcinoma of Head and Neck / pathology*
  • Squamous Cell Carcinoma of Head and Neck / surgery