{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:43:38Z","timestamp":1777383818534,"version":"3.51.4"},"reference-count":29,"publisher":"Royal College of Surgeons of England","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> Lymph node metastasis is a poor prognostic indicator and is well established in tongue squamous cell carcinoma. Based on the current staging system, accurate risk stratification is difficult. There is thus a need to evaluate an alternate method for predicting recurrence and survival. The objective of the study was to evaluate lymph node ratio as a prognostic marker as compared with N-staging for tongue squamous cell carcinoma. <\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p> We conducted a retrospective cohort study with 56 patients with a lymph node ratio greater than 0.012 (exposed) and 74 patients with a lymph node ratio less than 0.012 (unexposed). Overall five-year survival and disease-free survival were assessed. The Cox proportional hazard model was used to analyse lymph node ratio as a predictor of outcome, together with other covariates. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 130 patients were included in the study. Patients with lymph node ratio greater than 0.012 had a poor overall five-year (mean survival time 52.1 months vs 38.1 months) and disease-free survival (mean survival time 53.6 months vs 39.2 months). The hazard of death among patients with a lymph node ratio greater than 0.012 was 3.24 times higher than the hazard of death among patients with a lymph node ratio less than 0.012 (95% confidence interval 1.82\u20135.77). <\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p> Lymph node ratio is a superior prognostic marker compared with the currently used American Joint Committee on Cancer N-staging. Our findings also suggest that the margin status (involved) of the primary tumour resection adversely affects prognosis. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2020.0173","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T14:56:40Z","timestamp":1597762600000},"page":"726-732","source":"Crossref","is-referenced-by-count":9,"title":["Lymph node ratio as a prognostic marker of oral tongue squamous cell carcinoma: a cohort study"],"prefix":"10.1308","volume":"102","author":[{"given":"H","family":"Iftikhar","sequence":"first","affiliation":[{"name":"Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Rozi","sequence":"additional","affiliation":[{"name":"Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Zahid","sequence":"additional","affiliation":[{"name":"Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MS","family":"Awan","sequence":"additional","affiliation":[{"name":"Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KR","family":"Nathani","sequence":"additional","affiliation":[{"name":"Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.7314\/APJCP.2013.14.10.5567"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.3844\/ajptsp.2010.9.13"},{"key":"bib3","first-page":"195","volume":"7","author":"Bhurgri Y","year":"2006","journal-title":"Asia Pac J Cancer Prev"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80109-6"},{"key":"bib5","volume-title":"Cancer of the Head and Neck","author":"Shah JP","year":"2001"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(195105)4:3<441::AID-CNCR2820040303>3.0.CO;2-O"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0706-9"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.570"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24631"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-1614-6"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11325.x"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-3634-5"},{"key":"bib13","unstructured":"Edge SB, Byrd DR, Compton CC et al (eds). 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