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

Yoav P. Talmi, Robert P. Takes*, Eran E. Alon, Iain J. Nixon, Fernando López, Remco de Bree, Juan P. Rodrigo, Ashok R. Shaha, Gyorgy B. Halmos, Alessandra Rinaldo, Alfio Ferlito

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

42 Scopus citations


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.

Original languageEnglish
Pages (from-to)1082-1090
Number of pages9
JournalHead and Neck
Issue number5
StatePublished - May 2018


  • head and neck squamous cell carcinoma
  • lymph node metastasis
  • lymph node ratio
  • neck dissection
  • prognosis


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