The following is a summary of “Lymph node level ratio as a predictor of survival in oral cavity squamous cell carcinoma,” published in the November 2023  issue of Oncology by Dermody, et al.

For a study, researchers sought to determine whether or not nodal yields and ratios based on neck levels might serve as prognostic markers in patients with neck dissection. The study was conducted using a retrospective analysis of 342 individuals who had oral cavity squamous cell carcinoma (SCC) that had been surgically treated between the years 1998 and 2017.

According to the findings, overall and disease-specific survival was enhanced, which suggested that total nodal yield was related to increased survival. On the other hand, the total positive nodal yield, the positive nodal ratio per level, and the identification of less than four lymph nodes per level were all shown to be related to a worse overall and disease-specific survival rate. To be more precise, a ratio of at least four lymph nodes per level that was dissected produced the highest possible hazard ratio for both disease-specific and overall survival, hence optimizing the Kaplan-Meier split between survival groups.

After considering several different confounders, a nodal level ratio of four lymph nodes per level resulted in hazard ratios of 3.59 for disease-free survival and 2.90 for overall survival. The results of the study indicated that a nodal level ratio of less than four lymph nodes per level is linked to less favorable outcomes in oral cavity squamous cell carcinoma (SCC). The ratio is a possible qualitative measure and a predictive factor for survival. This level-specific method could provide wider value when addressing variances in the degrees of neck dissection.

Source: sciencedirect.com/science/article/abs/pii/S1368837523002683