{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:51:37Z","timestamp":1789649497422,"version":"4.0.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T00:00:00Z","timestamp":1516665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prognostic impact of the size and number of nodal metastases in head and neck cutaneous squamous cell carcinoma (SCC) is well established. The purpose of this study was to validate the prognostic significance of the lymph node ratio in metastatic head and neck cutaneous SCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of 326 patients with head and neck cutaneous SCC with parotid and\/or cervical nodal metastases was performed. The primary endpoints were overall survival (OS) and disease\u2010free survival (DFS). The minimal\u2010P approach was used to investigate the optimal lymph node ratio threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our data included 77 recurrences and 101 deaths. A lymph node ratio of 6% was a significant predictor of shorter DFS (hazard ratio [HR] 1.62; 95% confidence interval [CI] 1.11\u20102.38; <jats:italic>P<\/jats:italic>\u2009=\u2009.01) and OS (HR 1.63; 95% CI 1.03\u20102.58; <jats:italic>P<\/jats:italic>\u2009=\u20090.04) on multivariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The lymph node ratio is an independent prognosticator of survival outcomes in patients presenting with metastatic head and neck cutaneous SCC. A lymph node ratio &gt;6% is a significant threshold to categorize patients into low and high risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.25066","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T14:54:06Z","timestamp":1516719246000},"page":"993-999","source":"Crossref","is-referenced-by-count":30,"title":["Lymph node ratio as a prognostic factor in metastatic cutaneous head and neck squamous cell carcinoma"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1048-602X","authenticated-orcid":false,"given":"Kartik","family":"Vasan","sequence":"first","affiliation":[{"name":"Nepean Blue Mountains Local Health District Sydney Australia"},{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu\u2010Hui (Hubert)","family":"Low","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"},{"name":"Central Clinical School University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruta","family":"Gupta","sequence":"additional","affiliation":[{"name":"Central Clinical School University of Sydney Sydney Australia"},{"name":"Department of Tissue Pathology and Diagnostic Oncology Royal Prince Alfred Hospital Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4547-6611","authenticated-orcid":false,"given":"Bruce","family":"Ashford","sequence":"additional","affiliation":[{"name":"School of Biological Sciences University of Wollongong Wollongong Australia"},{"name":"Illawarra Health and Medical Research Institute (IHMRI) Wollongong Australia"},{"name":"Illawarra and Shoalhaven Local Health District (ISLHD) Wollongong Australia"},{"name":"Centre for Oncology Education and Research Translation (CONCERT) Liverpool Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Asher","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Gao","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"},{"name":"Central Clinical School University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"},{"name":"Central Clinical School University of Sydney Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"Clark","sequence":"additional","affiliation":[{"name":"Nepean Blue Mountains Local Health District Sydney Australia"},{"name":"Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse Sydney Australia"},{"name":"Central Clinical School University of Sydney Sydney Australia"},{"name":"South West Clinical School University of New South Wales Sydney 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