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.