Lymph node ratio and capsule penetration as independent risk factors in head and neck squamous cell carcinoma

INTRODUCTION: Knowledge of independent prognostic factors in patients with head and neck squamous cell carcinoma is important for appropriate treatment decisions. Given the availability of aggressive therapeutic options with known side effects and burdens for the patient, choosing the correct treatment option is vital. MATERIALS AND METHODS: Using a retrospective database of patients treated over a 10-year period, independent prognostic factors for disease-free survival and overall survival were assessed. Univariate analysis was used to identify significant variables, and multivariate Cox regression analysis was used to determine independent prognostic factors. RESULTS: Between 1 January 1999 and 31 December 2009, 291 patients with head and neck squamous cell carcinomas were analysed to identify prognostic factors for disease-free survival and overall survival. Although univariate analysis identified several significant factors, multivariate Cox regression analysis showed that capsule penetration and lymph node ratio were the only significant factors for disease-free survival and overall survival. CONCLUSION: Lymph node ratio is an independent predictor of survival and should be examined in every patient undergoing neck dissection. Capsule penetration of lymph nodes was another independent prognostic factor. In cases of capsule penetration or inappropriate lymph node ratio, adjuvant therapies are necessary.