Nutrition-immune-inflammation score (NIIS) plays an important role in the prognosis of external auditory canal carcinoma after surgery

Abstract

Background External auditory canal carcinoma (EACC) was a rare malignant tumor. This study was designed to investigate the relationship between the nutrition-immune-inflammation score (NIIS) and the prognosis of patients with resectable EACC. Methods A total of 45 resectable EACC patients diagnosed between July 2012 and May 2018 were enrolled from two medical institutions, and retrospectively reviewed. Kaplan–Meier method was used to estimate survival rates. Log-rank test was used to assess the impact of NIIS and other prognostic variables on overall survival (OS) and progression-free survival (PFS). Univariate analyses were performed by using the Cox risk regression method. Result All 45 patients underwent surgical resection, and 17 of them received postoperative radiotherapy. The 3-year and 5-year overall survival (OS) for the EACC patients was 68.9% and 57.7%, respectively. The 3-year and 5-year progression-free survival (PFS) for the EACC patients were 55.6% and 51.1%, respectively. Local recurrence (LR) occurred in 16 (35.6%) patients. 12 (26.7%) patients had distant metastasis (DM). NIIS was calculated from body mass index (BMI), C-reactive protein (CRP), lymphocytes, albumin, and hemoglobin. Univariate analysis showed that NIIS (P = 0.005), Pittsburgh stage Ⅲ-Ⅳ (P = 0.017), nerve invasion (P < 0.001), and positive surgical margin (P = 0.002) were significant factors for PFS in EACC patients. In the statistics of OS, we found that NIIS (P = 0.004), Pittsburgh stage Ⅲ-Ⅳ (P = 0.010), nerve invasion (P < 0.001), and radiotherapy (P = 0.041) were significant factors. Conclusion Our findings suggest that NIIS is an important biomarker that affects the prognosis of postoperative ESCC patients. In addition, for patients with resectable EACC, the absence of postoperative radiotherapy, advanced stage, positive surgical margins, and nerve invasion had a negative impact on prognosis.