Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Significance: The lymph node ratio (LNR) has been proposed to have prognostic value in predicting locoregional recurrence and overall survival of HPV-associated oropharyngeal carcinomas.
Objective: To determine the influence of LNR on survival in surgically managed human papillomavirus (HPV)-associated oropharyngeal cancer.
Methods: This is a cross-sectional study of surgically treated patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) in the NCDB from 2004-2018. Cumulative survival (CS) was assessed with Kaplan-Meier and Cox proportional hazard regression analyses.
Results: A total of 1,933 patients with HPV-associated OPSCC were included in the study. LNR >=0.10 was associated significantly worse 5-year cumulative survival compared to patients with LNR <0.10 (76% vs 84%, p = 0.003). After adjusting for comorbidities, TNM staging, and adverse pathological features, LNR >=0.10 was associated with an increased hazard of death (HR 1.573, 95% CI 1.073 - 2.307).
Conclusions: For patients with surgically managed HPV-associated oropharyngeal squamous cell carcinoma, LNR was associated with survival outcome and may warrant further investigation for prognostication in conjunction with the 8th edition AJCC staging guidelines.