Prognostic significance of combined pretreatment lymphocyte counts and body mass index in patients with head and neck cancer treated with radiation therapy

Abstract

We aimed to investigate the prognostic significance of combined pretreatment lymphocyte counts (LCs) and body mass index (BMI) in patients with head and neck cancer (HNC) treated with radiation therapy (RT). Nine hundred and twelve patients with HNC who were treated with RT were retrospectively reviewed. Survival was analyzed by stratifying the patients according to pretreatment LCs and BMI. Patients with low pretreatment LCs and BMI were characterized by a more advanced T stage, fewer nasopharyngeal subsites, less smoking and drinking, and fewer comorbidities. Patients with low pretreatment LCs and BMI had a significantly poorer overall and distant metastasis‐free survival than those with high pretreatment LCs and BMI. No significant differences were observed in terms of local or regional recurrence‐free survival. Combined pretreatment LCs and BMI may be more effective at predicting overall and distant metastasis‐free survival in patients with HNC treated with RT.

Preoperative prognostic nutritional index predicts prognosis of patients with oral cavity cancer

“…However, tumours may suppress lymphocyte activation and recruitment by inhibiting dendritic cell differentiation and activation, tumour‐associated macrophages, and the subsequent infiltration of the regulatory T cells (Mantovani et al., 2008). Wu et al investigated 912 patients with HNC and reported that patients with low pretreatment lymphocyte counts had significantly poorer OS and distant metastasis‐free survival than did those with high pretreatment lymphocyte counts (Wu et al., 2018). Taken together, a low PNI value may reflect lymphocytopaenia and/or hypoalbuminaemia, and both are indicators of poor prognosis in patients with OSCC (Milne et al., 2012; Schueneman et al., 2013).…”

Preoperative carcinoembryonic antigen to body mass index ratio contributes to prognosis prediction in colorectal cancer

“…High CBR associated with poor survival could be also understood from the perspective of inflammation. Previous studies indicated that CEA in patients with CRC could induce the secretion of IL-6, and that the levels of CEA and IL-6 were positively correlated (16,53). It was noted that IL-6 could induce fat loss in cancer cachexia via different approaches, such as promoting white adipose tissue lipolysis (54) and decreasing muscle mass (55), which could result in a decreased BMI in these patients (56).…”

“…For BMI, its application in prognosis was largely blocked by inconsistent criteria and conflicting results, as aforementioned ( 10 – 14 ). Similarly, some reports indicated that combining BMI with other markers, such as lymphocyte counts, could improve the prognostic efficacy for patients with head and neck cancer who underwent radiation therapy ( 16 ). Recently, Xie et al ( 42 ) conducted a study that included 2,471 patients with CRC and found that the neutrophil-BMI ratio was a useful prognostic marker.…”

“…Based on this background, it is reasonable to improve the prognostic efficacy of BMI with a combination of other markers. In fact, other studies have tried to combine BMI with other markers, including the NLR ( 15 , 16 ); however, these studies did not routinely report the prognostic efficacy of the new indicators or statistically compare them when it was generated.…”

Systemic immune-inflammation index as a prognostic marker in patients with newly diagnosed metastatic nasopharyngeal carcinoma: a propensity score-matched study

“…Tumor infiltrating lymphocytes (TILs) in NPC were common significantly associated with better survival, which was supposed to be an independent and potential prognostic biomarker (52). And several data have also showed that higher peripheral blood lymphocytes predicted a favorable outcome in NPC and other head and neck caner (18,45,53,54).…”