Background: The association between nodal ratio and survival in oral cavity carcinomas has recently been proposed, but no prospective evaluations exist.
Methods: We sought to determine, using an institutional database, whether nodal ratio impacts survival in node-positive oral cavity squamous cell carcinoma.
Results: Between 1994 and 2004, 143 new diagnoses of N(1-2) squamous cell carcinoma of the oral cavity were identified. The mean number of nodes identified was 41.6, and the mean nodal ratio was 9%. Nodal ratio was strongly statistically associated with overall and disease-specific survival in both univariate and multivariate analyses. No other prognostic indicator maintained that degree of statistical significance. Patients could be stratified into low (0% to 6%), moderate (6% to 13%), and high-risk (>13%) groups based on nodal ratio.
Conclusions: In squamous cell carcinoma of the oral cavity, an increased nodal ratio is a strong predictor of decreased survival. Risk of death can be stratified by nodal ratio.
(c) 2009 Wiley Periodicals, Inc. Head Neck, 2009.