Multivariate analysis of preoperative and postoperative neutrophil-to-lymphocyte ratio as an indicator of head and neck squamous cell carcinoma outcome

“…Accumulating evidence has shown that systemic inflammation plays an important role in different stages of tumor development, including initiation, promotion, malignant conversion, invasion, and metastasis. 6 , 7 Previous studies have confirmed that inflammatory biomarkers including preoperative neutrophil to lymphocyte ratio (NLR), preoperative derived neutrophil to lymphocyte ratio (dNLR), preoperative monocyte to lymphocyte ratio (MLR), preoperative platelet to lymphocyte ratio (PLR), preoperative systemic immune-inflammation index (SII), postoperative NLR, and difference in NLR before and after chemoradiotherapy (∆NLR) are associated with worse prognosis in various malignancies, 8 – 12 including esophageal cancer. 13 – 18 However, for ESCC undergoing nCRT, data regarding the relationship between pre- and post-treatment levels of inflammatory biomarkers and prognosis or adverse events was very limited.…”

Section: Introductionmentioning

confidence: 99%

<p>Predicting Prognosis and Adverse Events by Hematologic Markers in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy</p>

Cai¹,

Yu²,

Meng³

2020

CMAR

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Purpose: Our purpose was to evaluate the association between hematologic markers and mortality and adverse events in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT). Patients and Methods: A total of 311 patients with ESCC treated with nCRT from 2012 to 2014 were enrolled retrospectively. The Kaplan-Meier method with a Log rank test was used to calculate five-year overall survival (OS). Receiver operating characteristic (ROC) curves were plotted to determine the cutoff values for hematologic markers. Multivariate analysis was performed using Cox regression analysis model. Model performance was evaluated by predicted nomogram, concordance index (C-index) and calibration curve. Results: Median follow-up was 22 months. High pretreatment platelet to lymphocyte ratio (PLR, p = 0.047) and systemic immune-inflammation index (SII, p = 0.027) were significantly associated with pathologic complete response (pCR). In multivariate analysis, smoking history, Eastern Cooperative Oncology Group (ECOG) performance status, invasion depth, lymph node metastasis, PLR, and SII were independent factors to predict five-year OS. Multivariate analysis showed a lower neutrophil to lymphocyte ratio (NLR) at baseline (p = 0.007) was significantly associated with development of grade ≥3 hematologic toxicity, and none of inflammatory biomarkers could predict grade ≥3 non-hematologic toxicity or radiation pneumonitis (RP). Conclusion: SII and PLR were independent indicators to predict prognosis in patients with ESCC treated with nCRT, and a lower NLR at baseline was an independent indicator to predict grade ≥3 hematologic toxicity.

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“…While disease stage is the single most predictive prognostic factor, there is still heterogeneity in outcomes within a single stage 5 . Current models for predicting survival and efficacy of therapy in head and neck cancer are still inadequate 6 . With growing diversity in treatment regimens available and an increased push to personalize therapy, there is a need to develop a robust repertoire of prognostic indicators to better predict therapeutic response.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil‐to‐lymphocyte ratio as a prognostic indicator for overall and cancer‐specific survival in squamous cell carcinoma of the head and neck

et al. 2020

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Background Neutrophil‐to‐lymphocyte ratio (NLR) is a biomarker that is correlated with systemic inflammation and poor prognosis in solid tumors. We investigated the value of NLR in predicting survival in a large population of head and neck cancer patients in the United States. Methods We performed a retrospective cohort study of Veterans Affairs patients with head and neck squamous cell carcinoma (HNSCC) diagnosed between January 2000 and December 2017. We compared 5‐year overall survival and cancer‐specific survival for different NLR tertiles using cox proportional hazards modeling with adjustment for covariates. Results The primary cohort consisted of 14 644 subjects of which 99% were male. Relative to patients with NLRs in the lower tertile, patients with NLRs in the top tertile had an 71% increased hazard of all‐cause mortality (P < .001) and 44% increased hazard of cancer‐specific mortality (P < .001) at 5 years. Conclusions Elevated NLR in HNSCC confers a poor prognosis.

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Multivariate analysis of preoperative and postoperative neutrophil-to-lymphocyte ratio as an indicator of head and neck squamous cell carcinoma outcome

Cited by 10 publications

References 39 publications

Evaluation of Optimal Threshold of Neutrophil-Lymphocyte Ratio and Its Association With Survival Outcomes Among Patients With Head and Neck Cancer

Evaluation of Optimal Threshold of Neutrophil-Lymphocyte Ratio and Its Association With Survival Outcomes Among Patients With Head and Neck Cancer

<p>Predicting Prognosis and Adverse Events by Hematologic Markers in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy</p>

Neutrophil‐to‐lymphocyte ratio as a prognostic indicator for overall and cancer‐specific survival in squamous cell carcinoma of the head and neck

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