Lymph-Node Ratio in Patients with Cutaneous Melanoma: A Multi-Institution Prognostic Study

Pasquali Sandro, Maurichi Andrea, Mozzillo Nicola, Mocellin Simone, Macripò Giuseppe, Borgognoni Lorenzo, Solari Nicola, Piazzalunga Dario, Mascheroni Luigi, Giudice Giuseppe, Patuzzo Roberto, Caracò Corrado, Ribero Simone, Marone Ugo, Santinami Mario, Rossi Carlo Riccardo

Research output: Contribution to journalArticlepeer-review


Background: Lymph node ratio (LNR)—the number of metastatic lymph nodes (LNs) over the number of excised LNs after lymphadenectomy—is a prognostic factor for many solid tumors, but controversies still exist for skin melanoma. We investigated the prognostic relevance of LNR in melanoma patients and formulated a proposal for considering the LNR in the current American Joint Committee on Cancer (AJCC) N staging system. Methods: Retrospective data of 2,526 melanoma patients with LN metastasis from nine Italian institutions were collected in a multicenter database. The prognostic value of the LNR (categorized as A, ≤0.1; B, 0.11–0.25; and C, >0.25) was assessed by multivariable survival analysis. Results: LNR was a significant independent prognostic factor for melanoma-specific survival (LNR B vs. A: hazard ratio [HR] 1.47, 95 % CI 1.16–1.87, p = 0.002; LNR C vs. A: HR 1.84, 95 % CI 1.29–2.61, p = 0.001). The LNR had prognostic value in patients with AJCC N1a (one positive LN after sentinel LN biopsy [SLNB], HR 2.33, 95 % CI 1.49–3.63, p 

Original languageEnglish
Pages (from-to)2127-2134
Number of pages8
JournalAnnals of Surgical Oncology
Issue number7
Publication statusPublished - Jul 8 2015

ASJC Scopus subject areas

  • Surgery
  • Oncology


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