Systemic inflammatory markers as independent prognosticators of head and neck squamous cell carcinoma

Head Neck. 2015 Jan;37(1):103-10. doi: 10.1002/hed.23567. Epub 2014 Apr 15.

Abstract

Background: The purpose of this study was to investigate the prognostic value of the pretreatment inflammatory markers platelet-to-lymphocyte ratio (PLR) and the neutrophil-to-lymphocyte ratio (NLR) in patients with head and neck squamous cell carcinoma (HNSCC).

Methods: We conducted a retrospective analysis of patients diagnosed with HNSCC at McGill University Health Center from 2000 to 2011 (273 patients were retained). Hematologic parameters were recorded within 4 weeks of diagnosis. Mortality and recurrence rates were compared according to various PLR and NLR thresholds.

Results: Of the total patients, 20.5% died and 11.0% had disease recurrence. PLR >170 was associated with higher mortality (p = .008). The subgroup with a combination of PLR >170 and NLR ≤3.0 was associated with higher T classification and highest mortality (43%). NLR above 4.2 predicted higher rates of recurrence (p < .0001). The NLR/PLR combination was at least as good as TNM staging in predicting survival.

Conclusion: PLR is an independent predictor of mortality; NLR is an independent predictor of recurrence in HNSCC. These parameters might be used to identify advanced stages rapidly and economically.

Keywords: head and neck; inflammation; mortality; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; recurrence; squamous cell cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / mortality*
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / blood*
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / mortality*
  • Humans
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / epidemiology
  • Neutrophils*
  • Platelet Count*
  • Predictive Value of Tests
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate

Substances

  • Biomarkers