Prognostic Value of Neutrophil Percentage-to-Albumin Ratio in Patients with Oral Cavity Cancer

Abstract

This study investigated preoperative neutrophil percentage-to-albumin ratio (NPAR) for predicting oral cavity squamous cell carcinoma (OSCC) survival. We retrospectively analyzed 368 patients who received curative OSCC surgery between 2008 and 2017. Receiver operating characteristic curve analyses were employed to identify the optimal NPAR cutoff (16.93), and the patients were then separated into low-NPAR and high-NPAR groups. Intergroup differences in survival were determined through Kaplan–Meier analysis and log-rank tests. Disease-free survival (DFS) and overall survival (OS) predictors were identified using Cox proportional-hazards models. A nomogram integrating independent prognostic factors was proposed to increase the accuracy of OS prediction. A high NPAR (≥16.93) was associated with worse median OS and DFS than was a low NPAR (both p < 0.001); this finding was confirmed through multivariate analyses (hazard ratio (HR) for OS = 2.697, p < 0.001; and HR for DFS = 1.671, p = 0.008). The nomogram’s favorable predictive ability was confirmed by the calibration plots and concordance index (0.784). The preoperative NPAR is thus a promising prognostic biomarker in patients with OSCC after external validation in a larger cohort. Our nomogram can facilitate clinical use of the NPAR and provides accurate individualized OS predictions.

Neutrophil percentage to albumin ratio is associated with stroke-associated pneumonia and poor outcome in patients with spontaneous intracerebral hemorrhage

“…In combination, neutrophils and albumin may be more valuable and reliable biomarkers for predicting outcomes across various diseases, providing both nutritional and acute inflammatory information. The NPAR has been studied as an independent prognostic marker in patients with anti-N-methyl-D-aspartic acid receptor encephalitis, malignancy, and other diseases ( 35 – 37 ). One study reported that NPAR proved to be an independent predictor of short-term outcomes in acute ischemic stroke patients who received reperfusion therapy ( 37 ).…”

The neutrophil percentage-to-albumin ratio is an independent risk factor for poor prognosis in peritoneal dialysis patients

“…Such a hypothesis has been confirmed in many nonrenal diseases. For example, many studies suggest that the NPAR may predict poor outcomes in patients with various types of cancer, and its predictive capacity is better than that of neutrophil percentage or albumin alone [ 7 ]. On the other hand, high levels of NPAR have been shown as an independent risk factor for all-cause mortality in patients with various cardio-cerebrovascular diseases, such as atrial fibrillation, coronary heart disease, heart failure [ 21 ], and stroke [ 10 ].…”

“…The neutrophil percentage-to-albumin ratio (NPAR), which is the ratio of neutrophil percentage (Neu%) to serum albumin (ALB), is a recently discovered indicator for predicting prognosis in many diseases. For example, increased NPAR has been found to be associated with poor outcomes in many cancer patients [ 7 ]. Likewise, high levels of NPAR have been suggested as an independent risk factor for all-cause mortality in patients with cardiovascular diseases [ 8–10 ].…”

Platelet-to-Albumin Ratio: The Prognostic Utility in the Prediction of 2-Month Postoperative Heart Transplant Complications

“…Another highly investigated marker is NPAR. The NPAR cut-off levels included in our study have been investigated in the prognosis of oral cavity cancer, bladder cancer, and cardiogenic shock [ 15 , 16 , 17 , 18 , 19 ] ( Table 1 ). All the cut-off levels will be later analyzed in logistic regression.…”