Pretreatment hemoglobin level as a prognostic factor in patients with locally advanced head and neck squamous cell carcinoma

Melo-Alvim, Cecília; Miguel-Semedo, Patrícia; Paiva, R.; Lobo-Martins, Soraia; Luna-Pais, Helena; Costa, Andreia; Santos, Ana Rita; Florindo, André; Vasconcelos, Ana Luísa; Abrunhosa-Branquinho, André; Palmela, Paulo; Fernandes, Leonor; Presa, Dolores; Lopes-da-Costa, Luís; Ribeiro, Leonor

doi:10.1016/j.rpor.2020.07.002

Cited by 8 publications

(7 citation statements)

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“…The adverse impact in patients with low Hb before treatment has been well documented in head and neck cancer patients treated with (chemo)radiation. [5,6,8,10,15] The mechanism underlying poor prognosis remains discussed. It is suggested that low Hb concentration may exacerbate the preexisting tumor hypoxia and, hence, impeding the response of tumor cells to cytotoxic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…[3,4] Previous literature have showed that low hemoglobulin is associated with worse local control and survival. [5][6][7][8] Low hemoglobulin is supposed to lead to decreased cell oxygenation and contribute to chemoradiation resistance via oxygen deprivation. [9,10] In ammatory responses in tumor microenvironment can be re ected by some common markers in peripheral blood, such as lymphocytes, neutrophils, monocytes, and platelets.…”

Section: Introductionmentioning

confidence: 99%

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A Predictive Mortality Model for Advanced Oropharyngeal Cancer Patients Treated with Chemoradiation

Chang

et al. 2022

Preprint

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Background: To analyze clinical characteristics in the prediction of early mortality (within 1 year) in advanced oropharyngeal cancer patients treated with chemoradiation. Methods: 147 advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed.Results: The 1-year overall mortality for all patients was 29% [95% confidence interval (CI): 23-37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 gm/dl was an independent indicator of early mortality [Odds ratio (OR) 5.85, 95% CI 2.17-15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of early mortality (OR 4.78, 95% CI 1.44-15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict early mortality. The c-index of the model was 0.75 (95%CI 0.66-0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91% and 71% versus 53% and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73% and 28%, respectively; p < 0.001). Conclusions: The pre-treatment Hb < 13.5 gm/dl and SII ≥ 1820 are associated with higher risks of early mortality in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Predictive Mortality Model for Advanced Oropharyngeal Cancer Patients Treated with Chemoradiation

Chang

et al. 2022

Preprint

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“…In order to minimize this influence, Hgb/RDW ratio (HRR) was found to be a more reliable parameter for survival prognosis in various solid tumors. The HRR is a simple prognostic marker first proposed in 2016 for esophageal cancer (24), and has been shown to also have prognostic value for cancer of gastric (25), bladder (26), renal (27), head and neck (28), SCLC (29) and NSCLC (30). Those studies suggested that a low HRR is associated with poor prognosis.…”

Section: Original Articlementioning

confidence: 99%

Preoperative hemoglobin-to-red cell distribution width ratio as a prognostic factor in pulmonary large cell neuroendocrine carcinoma: a retrospective cohort study

Zhao¹,

Shi²,

Zhang³

2022

Ann Transl Med

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Background: The hemoglobin (Hgb)/red cell distribution width (RDW) ratio (HRR) is a simple prognostic marker for small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), but no data are available for pulmonary large cell neuroendocrine carcinoma (PLCNEC). This study aimed to assess the potential prognostic role of preoperative HRR in PLCNEC.Methods: This single-center retrospective study included patients with PLCNEC who underwent surgery at Shanghai Pulmonary Hospital from January 2012 to August 2016. The follow-up was censored in August 2020. The participants were grouped as low/high HRR according to their optimal value calculated using a receiver operating characteristic (ROC) curve. Univariable and multivariable Cox analysis were performed to identify the risk factors for overall survival (OS).Results: A total of 80 patients with PLCNEC were included. The optimal cutoff values were 0.969 for HRR. Compared with the high HRR group, the low HRR group had a lower mean Hgb (12.1 vs. 14.1 g/dL, P<0.001), lower mean albumin-globulin ratio (AGR) (1.4 vs. 1.6, P=0.017), and higher median RDW (14.5% vs. 12.9%, P<0.001). The median OS was 30.0 months [95% confidence interval (CI): 13.4 to 46.5 months].Participants in the low HRR group exhibited a poorer OS than those with high HRR (20.3 months, 95% CI: 14.5 to 26.1 months vs. not reached, P<0.001). The multivariable analysis showed that low HRR was significantly associated with poor OS [hazard ratio (HR) =3.16, 95% CI: 1.69 to 5.93, P<0.001].Conclusions: Low HRR is associated with poor OS in patients with PLCNEC and can be used as an inexpensive prognostic factor in patients undergoing PLCNEC resection.Keywords: Pulmonary large cell neuroendocrine carcinoma (PLCNEC); hemoglobin (Hgb); red blood cell distribution ratio; hemoglobin-to-red blood cell distribution ratio (HRR); overall survival (OS)

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“…In recent years, tumor oxygenation and antitumoral immunity are two main issues related to the tumor microenvironment that are progressively explored to elucidate the higher sensitivity to chemoradiation and the better outcomes, as well as in the view of evolving new diagnosis and prognosis tools [ 3 , 4 ]. Previous literature have showed that low hemoglobulin is associated with worse local control and survival [ 5 – 8 ]. Low hemoglobulin is supposed to lead to decreased cell oxygenation and contribute to chemoradiation resistance via oxygen deprivation [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation

Chang

et al. 2022

BMC Cancer

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Background To analyze clinical characteristics in the prediction of death within 1 year in advanced oropharyngeal cancer patients treated with chemoradiation. Methods One hundred forty-seven advanced oropharyngeal cancer patients who underwent curative-intent chemoradiation treatment were retrospectively enrolled. The pre-treatment clinical parameters including inflammatory markers were reviewed. Results The 1-year death rate for all patients was 29% [95% confidence interval (CI): 23–37%]. In multivariate logistic regression analysis, hemoglobulin (Hb) < 13.5 g/dl was an independent indicator of death within 1-year [Odds ratio (OR) 5.85, 95% CI 2.17–15.75, p < 0.001]. Systemic immune inflammation (SII) ≥ 1820 was also a significant factor for prediction of death within 1 year (OR 4.78, 95% CI 1.44–15.85, p = 0.011). We further used gander, age, Hb and SII to develop a nomogram to predict death within 1 year. The c-index of the model was 0.75 (95%CI 0.66–0.83). For patients with low nomogram score (< 14) versus high nomogram score (≥ 14), the 1-year and 2-year OS rates were 91 and 71% versus 53 and 29%, respectively. (p < 0.001). A difference in the disease persistence or recurrence rate between patients with high and low nomogram score was significant (73 and 28%, respectively; p < 0.001). Conclusions The pre-treatment Hb < 13.5 g/dl and SII ≥ 1820 are associated with higher risks of death within 1-year in patients with advanced oropharyngeal cancers. Nomogram can aid in patient counseling and treatment modality adjustment. The development of a more effective treatment protocol for patients with high nomogram score will be essential.

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Pretreatment hemoglobin level as a prognostic factor in patients with locally advanced head and neck squamous cell carcinoma

Cited by 8 publications

References 28 publications

A Predictive Mortality Model for Advanced Oropharyngeal Cancer Patients Treated with Chemoradiation

A Predictive Mortality Model for Advanced Oropharyngeal Cancer Patients Treated with Chemoradiation

Preoperative hemoglobin-to-red cell distribution width ratio as a prognostic factor in pulmonary large cell neuroendocrine carcinoma: a retrospective cohort study

A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation

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