为了评估基于水平的淋巴结收获量和比率是否可作为接受颈淋巴清扫术的口腔腔内鳞状细胞癌患者的预后指标，对1998年至2017年间接受手术治疗的342例口腔腔内鳞状细胞癌患者进行了回顾性分析。收集了人口统计学和临床病理学数据。通过Kaplan-Meier方法和log-rank检验以及单变量和多变量Cox模型分析了疾病特异性生存和总体生存。总淋巴结收获量与改善总体和疾病特异性生存有关（p<0.01）。总阳性淋巴结收获量（p<0.01）、每一水平的阳性淋巴结比率（p<0.001）以及每一水平找到<4个淋巴结（p<0.001）与更差的疾病特异性生存和总体生存有关。每一水平淋巴结切除至少4个淋巴结的比率可使疾病特异性生存和总体生存的危险比最大化，并优化Kaplan-Meier分组之间的生存差异。在Cox模型中，控制性别、年龄、切缘状态、疾病分期、淋巴结外生长、神经外膜浸润和淋巴管膜浸润等固定协变量后，每一水平淋巴结比率为4个淋巴结/水平的危险比（95% CI）为3.59（1.69, 7.60；p<0.0006），用于无疾病存活期和2.90（1.54, 5.46；p<0.001）用于总体生存。每一水平淋巴结比率<4个淋巴结/水平与口腔腔内鳞状细胞癌的较差疾病特异性生存和总体生存有关。这种级别特异性的度量方法在定性上可能是有用的，并可用于预测广泛应用于不同水平的颈淋巴清扫程度的口腔腔内癌生存。版权所有©2023 Elsevier Ltd. 保留所有权利。

To evaluate whether nodal yields and ratios based on level serves as prognostic indicators in patients with oral cavity squamous cell carcinoma undergoing neck dissection.A retrospective analysis of 342 patients with oral cavity squamous cell carcinoma treated surgically between 1998 and 2017 were included.Demographics and clinicopathologic data were collated. Disease specific survival and overall survival were analyzed via Kaplan-Meier method and log-rank test as well as univariable and multivariable Cox models.Total nodal yield is associated with improved overall and disease specific survival (p < 0.01). Total positive nodal yield (p < 0.01), positive nodal ratio per level (p < 0.001), and identification of <4 lymph nodes/level (p < 0.001) are associated with worse disease specific survival and overall survival. A ratio of at least 4 lymph nodes/level dissected yields the maximal hazard ratio on for both disease specific and overall survival optimizes the Kaplan-Meier split between survival groups. After controlling for sex, age, margin status, disease stage, extranodal extension, perineural invasion, and lymphovascular invasion as fixed covariates in the Cox models, a nodal level ratio of 4 lymph nodes/level provides hazard ratio (95% CI) of 3.59 (1.69, 7.60); p < 0.0006) for disease free survival and 2.90 (1.54, 5.46; p < 0.001) for overall survival.Nodal level ratio of < 4 lymph nodes/level is associated with worse disease specific and overall survival in oral cavity squamous cell carcinoma. This level-specific metric may prove useful qualitatively and in predicting survival in oral cavity cancer with broader utility to address variations in levels of neck dissection performed.Copyright © 2023 Elsevier Ltd. All rights reserved.