The medical charts of all patients with previously untreated locoregionally advanced SCC of the oropharynx, hypopharynx, larynx, and oral cavity who were treated in the Osaka University Hospital between January 2004 and December 2012 were subjected to a retrospective review. Our cancer registry system identified 391 consecutive patients with histologically confirmed HNSCC. Thirty-five patients were excluded because the period of observation was less than 24 months and their clinical or laboratory data were insufficient. Finally, 356 patients were included in the training set. The clinicopathological characteristic and laboratory results of the resultant 356 patients were used to assess the association of transaminase activity, AST/ALT ratio, and prognosis and to determine the cut-off value of the AST/ALT ratio. The clinical stage was determined according to the Union for International Cancer Control TNM classification system, 7th edition. The initial workup for these patients included a contrast-enhanced computed tomography (CT) of the neck, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with or without CT, and panendoscopy.