Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study

Abstract This study aimed to address the prognostic value of positive lymph node ratio for oral cavity squamous cell carcinoma (OCSCC) patients after neoadjuvant treatment, and build a prediction nomogram model. Patients with OCSCC with neoadjuvant treatment were retrieved from the Surveillance, Epi...

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Main Authors: Sufeng Fan, Shunv Cai, Yun Cheng, Yimin Wu, Wenmei Jiang
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-03048-x
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author Sufeng Fan
Shunv Cai
Yun Cheng
Yimin Wu
Wenmei Jiang
author_facet Sufeng Fan
Shunv Cai
Yun Cheng
Yimin Wu
Wenmei Jiang
author_sort Sufeng Fan
collection DOAJ
description Abstract This study aimed to address the prognostic value of positive lymph node ratio for oral cavity squamous cell carcinoma (OCSCC) patients after neoadjuvant treatment, and build a prediction nomogram model. Patients with OCSCC with neoadjuvant treatment were retrieved from the Surveillance, Epidemiology, and End Results database from 2004 to 2021. The primary outcome was overall survival (OS), and the second outcome was disease-specific survival (DSS). Kaplan–Meier and log-rank tests were used to analyze the survival outcomes. Univariable and multivariable analyses were conducted, and then a nomogram was constructed. A total of 419 were included in this study. The optimal cutoff value of the positive lymph node ratio (LNR) was 7.0%. The 5-year OS of patients with low LNR was significantly improved over those with high LNR (p < 0.0001). LNR > 7.0% (HR 50.7, 95% CI 19.7–130.5), and unmarried status (HR 1.33, 95% CI 1.03–1.70) were the independent risk factors for OS (all p < 0.05). LNR > 7.0% (HR 35.8, 95% CI 9.63–132.7), gum primary site (HR 0.330, 95% CI 0.132–0.827), and preoperative chemotherapy and radiotherapy (HR 2.91, 95% CI 1.78–4.73) were the independent risk factors for DSS (all p < 0.05). According to the nomogram, patients were stratified into the high-risk group and the low-risk group for OS and DSS. Patients in the low-risk group were predicted with superior survival (both p < 0.05). The LNR was an independent prognostic factor of the OS and DSS for OCSCC patients after neoadjuvant treatment. The tools may be valuable to guide multidisciplinary teams in making treatment decisions.
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spelling doaj-art-5a9a17f8aedf43fba5d99166a77a0a252025-08-20T03:48:18ZengNature PortfolioScientific Reports2045-23222025-05-0115111110.1038/s41598-025-03048-xPrognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world studySufeng Fan0Shunv Cai1Yun Cheng2Yimin Wu3Wenmei Jiang4Department of Oncology, Henan Provincial People’s HospitalDepartment of Anaesthesiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Anaesthesiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Anaesthesiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesDepartment of Anaesthesiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesAbstract This study aimed to address the prognostic value of positive lymph node ratio for oral cavity squamous cell carcinoma (OCSCC) patients after neoadjuvant treatment, and build a prediction nomogram model. Patients with OCSCC with neoadjuvant treatment were retrieved from the Surveillance, Epidemiology, and End Results database from 2004 to 2021. The primary outcome was overall survival (OS), and the second outcome was disease-specific survival (DSS). Kaplan–Meier and log-rank tests were used to analyze the survival outcomes. Univariable and multivariable analyses were conducted, and then a nomogram was constructed. A total of 419 were included in this study. The optimal cutoff value of the positive lymph node ratio (LNR) was 7.0%. The 5-year OS of patients with low LNR was significantly improved over those with high LNR (p < 0.0001). LNR > 7.0% (HR 50.7, 95% CI 19.7–130.5), and unmarried status (HR 1.33, 95% CI 1.03–1.70) were the independent risk factors for OS (all p < 0.05). LNR > 7.0% (HR 35.8, 95% CI 9.63–132.7), gum primary site (HR 0.330, 95% CI 0.132–0.827), and preoperative chemotherapy and radiotherapy (HR 2.91, 95% CI 1.78–4.73) were the independent risk factors for DSS (all p < 0.05). According to the nomogram, patients were stratified into the high-risk group and the low-risk group for OS and DSS. Patients in the low-risk group were predicted with superior survival (both p < 0.05). The LNR was an independent prognostic factor of the OS and DSS for OCSCC patients after neoadjuvant treatment. The tools may be valuable to guide multidisciplinary teams in making treatment decisions.https://doi.org/10.1038/s41598-025-03048-xOral cavity squamous cell carcinomaNeoadjuvant treatmentLymph node ratioOverall survivalNomogram
spellingShingle Sufeng Fan
Shunv Cai
Yun Cheng
Yimin Wu
Wenmei Jiang
Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study
Scientific Reports
Oral cavity squamous cell carcinoma
Neoadjuvant treatment
Lymph node ratio
Overall survival
Nomogram
title Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study
title_full Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study
title_fullStr Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study
title_full_unstemmed Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study
title_short Prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment: a retrospective real-world study
title_sort prognostic value of positive lymph node ratio in oral cavity squamous cell carcinoma after neoadjuvant treatment a retrospective real world study
topic Oral cavity squamous cell carcinoma
Neoadjuvant treatment
Lymph node ratio
Overall survival
Nomogram
url https://doi.org/10.1038/s41598-025-03048-x
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