Sahovaler et al studied patients with cutaneous squamous cell carcinoma of the head and neck with regional lymph node metastases. The authors are from Western University (London, Ontario), Italian Hospital of Buenos Aires and McMaster University.
Patient selection: cutaneous squamous cell carcinoma of the head and neck with lymph node metastases
Predictors of mortality:
(1) immunosuppression (hazard ratio 2.7)
(2) extra-capsular spread from lymph nodes (hazard ratio 1.9)
(3) failure to give adjuvant radiotherapy (hazard ratio 0.45 with radiotherapy)
(4) lymph node ratio (hazard ratio 1.9; specific cutoff not given; some use >= 6%)
(5) advanced age (hazard ratio 1.03 per year; will use >= 65 years in implementation)
lymph node ratio =
= (number of positive lymph nodes) / (number of lymph nodes removed)
The risk of mortality increases with the number of risk factors present.
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