{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:58:37Z","timestamp":1782125917617,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T00:00:00Z","timestamp":1588118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the utility of lymph node ratio (LNR) as a prognostic factor for survival and recurrence in surgically treated patients with human papillomavirus (HPV)\u2010related oropharyngeal squamous cell carcinoma (OPSCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective cohort study of a tertiary healthcare system in a major metropolitan area, we reviewed 169 consecutive patients with HPV\u2010related OPSCC treated using transoral robotic surgery. Univariable and multivariable Cox proportional hazards regression analysis with stratified models were used to compare LNR with other traditional clinicopathologic risk factors forrecurrence and survival. An LNR cutoff was found using the minimal <jats:italic>P<\/jats:italic> approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariable Cox regression models showed that each additional percentage increase in LNR corresponded to an adjusted hazard ratio (HR) of 1.04 (confidence interval [CI] 1.02\u20131.07). LNR was more significant when adjusted for adequate lymph node yield of \u2265\u200918 nodes (HR 5.05, 95% confidence interval [CI] 1.38\u201318.47). The minimal <jats:italic>P<\/jats:italic> generated cutoff point at LNR\u2009\u2265\u200917% demonstrated a HR 4.34 (95% CI 1.24\u201315.2) for disease\u2010free survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For HPV\u2010related OPSCC, continuous LNR and an LNR threshold of 17% could be helpful in identifying recurrent disease in addition to measures such as lymph node number alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence: 4<\/jats:title><\/jats:sec>","DOI":"10.1002\/lary.28689","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T18:47:12Z","timestamp":1588186032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Lymph Node Ratio in <scp>HPV<\/scp>\u2010Associated Oropharyngeal Cancer: Identification of a Prognostic Threshold"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-0399","authenticated-orcid":false,"given":"Daniel D.","family":"Bu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai  New York New York U.S.A."},{"name":"Department of Population Health\u2014Health Policy Icahn School of Medicine at Mount Sinai  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2092-0296","authenticated-orcid":false,"given":"Rocco","family":"Ferrandino","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Population Health\u2014Health Policy Icahn School of Medicine at Mount Sinai  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett A.","family":"Miles","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marita S.","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Icahn School of Medicine at Mount Sinai  New York New York 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