“…Since metastatic lymph node burden is one of the most important prognostic indicators of head and neck cancers [4,[32][33][34], and can increase the recurrence rate and mortality [33,35], a variety of features of lymph nodes as prognostic indicators for head and neck cancer, were investigated thoroughly. As for LHSCC, extracapsular spread (ECS) [35], number of positive lymph nodes [12,13,32], and lymph node yield [18,36,37] were reported. In recent years, several studies suggested that LNR or LND was an independent risk factor for patients with head and neck cancers [4,33,[37][38][39], including LHSCC [13-16, 18, 19, 21, 22], while some other studies found no significant relationship between survival and the LNR or LND for LHSCC [12,40].…”