Dr. Supreet Bhatt, Dr. Aditya Kunte, Dr. Manish Sadhwani


Introduction: Lymph node ratio as a prognostic marker remains under- evaluated as a prognostic marker in the neo-adjuvant setting. We aim to investigate its utility as a prognostic marker in locally advanced buccal mucosal cancers undergoing surgery after receiving neo- adjuvant chemotherapy.

Methodology:125 patients of T4b buccal mucosal squamous cell carcinomas received neoadjuvant chemotherapy. Responders to chemotherapy underwent curative resections and were included in the study. Histopathology reports were analysed for total lymph node yield from the neck dissections and lymph node ratio, which was correlated with clinical outcomes.

Results: 61 patients showed at least a partial response to chemotherapy and underwent surgery. 33% patients had positive neck nodes. Average lymph node yield was 23.63 (+/- 7.37). Average lymph node ratio in node positive patients was 0.073 (+/- 0.1). 18.03% patients had a recurrence over a 2 year follow up period. Average lymph node ratio in patients with recurrence and those without was 0.073 (+/- 0.1) and 0.07 (+/- 0.097) respectively.

Conclusion: Lymph node ratio does not show promise as a prognostic marker in locally advanced buccal mucosal cancers undergoing surgery after neo-adjuvant chemotherapy


Lymph node ratio, buccal mucosa cancer, neck dissection, neo-adjuvant chemotherapy

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