Pre-treatment absolute lymphocyte count predicts for improved survival in human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma

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

“… 50 In contrast, other studies found that high NLR was an adverse prognostic factor for survival outcomes even in the HPV era. 18 , 51 , 52 , 53 , 54 In addition, another study suggested HPV-associated head and neck cancers were also less likely to have high NLR, 53 which was not observed in our study. These discrepancies may be due to the heterogeneous nature of tumor biology among HPV-associated head and neck cancers based on smoking history.…”

Tumour-infiltrating lymphocytes in oropharyngeal cancer: a validation study according to the criteria of the International Immuno-Oncology Biomarker Working Group

“…Limitations of our present findings include the retrospective nature of the study, and the fact that it was based on a single-institution cohort. Of note, our findings are supported by recent studies on cancers of the oropharynx [ 40 , 41 ] and other subsites of the head and neck [ 12 , 23 , 48 ], as well as other locations [ 14 , 19 , 32 ] reporting prognostic usefulness of TILs in HE-stained sections. In addition, the method of assessment used in this study is well-defined and reported to yield good reproducibility and reliability as a prognostic marker in various cancers [ 11 , 14 ].…”

“…Findings of the present study indicate that those HPV+ OPSCC patients who could benefit from de-escalation may be identified by assessing their immune response to cancer cells. Our study reports that the TIL score is a good representative of an immune response which significantly relates to patient survival, as also reported elsewhere [ 40 , 41 ]. We suggest that assessment of TILs should be included in pathology reports and considered in clinical risk stratification of OPSCC.…”

Pretreatment Lymphocyte Count Predicts Benefit From Concurrent Chemotherapy With Radiotherapy in Oropharyngeal Cancer

“…For example, in a 2015 study of 702 OPSCC cases managed with definitive (chemo)radiotherapy, high pretreatment ALC led to better OS in patients with HPV-positive (n = 510; HR = 0.8; 95% CI, 0.62 to 1.03; P = .081) and HPV-negative (n = 192; HR = 0.82; 95% CI, 0.63 to 1.07; P = .14) disease; however, precision around the HR was poor. 20 A recent study by Kreinbrink et al 22 of 201 OPSCCs treated with primary (75%) or postoperative (25%) radiotherapy found pretreatment ALCs were not associated with OS as either a continuous (HR 0.9; 95% CI, 0.6 to 1.3; P = .6) or categorical (HR 0.7; 95% CI, 0.4 to 1.3; P = .2) variable. Three other studies assessing the NLR reported prognostic significance, but dichotomized NLR values solely on the sample median.…”

“…17,18 Pretreatment ALC may be a prognostic biomarker in OPSCC, 19 but published findings were mixed (Data Supplement, online only). [20][21][22] This may reflect small patient numbers, confounders including use of induction chemotherapy, and dichotomizing ALC rather than using as a continuous variable. The neutrophil: lymphocyte ratio (NLR) is an alternative biomarker for systemic immunosuppression, where high absolute neutrophil counts (ANCs) represent inflammation, which is also associated with inferior survival.…”