Neutrophil-to-lymphocyte ratio: Prognostic indicator for head and neck squamous cell carcinoma

Nicholas Rosculet; Xian Chong Zhou; Patrick Ha; Mei Tang; Marshall A Levine; Geoffrey Neuner; Joseph Califano

doi:10.1002/hed.24658

Neutrophil-to-lymphocyte ratio: Prognostic indicator for head and neck squamous cell carcinoma

Head Neck. 2017 Apr;39(4):662-667. doi: 10.1002/hed.24658. Epub 2017 Jan 11.

Authors

Nicholas Rosculet¹, Xian Chong Zhou², Patrick Ha^{3

4

5}, Mei Tang⁶, Marshall A Levine^{6

7}, Geoffrey Neuner⁶, Joseph Califano^{3

4

8}

Affiliations

¹ Johns Hopkins University School of Medicine, Baltimore, Maryland.
² Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
³ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
⁴ Milton J. Dance Jr. Head and Neck Center, Greater Baltimore Medical Center, Baltimore, Maryland.
⁵ Head and Neck Oncologic Surgery, Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, CA.
⁶ Department of Oncology, Greater Baltimore Medical Center, Baltimore, Maryland.
⁷ Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, Maryland.
⁸ Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of California, San Diego, CA.

PMID: 28075517
DOI: 10.1002/hed.24658

Abstract

Background: The neutrophil-to-lymphocyte ratio (NLR) has prognostic significance for many cancers, with higher values correlating with poor outcomes. The purpose of this study was to determine the prognostic significance of this inflammatory marker for patients with head and neck squamous cell carcinoma (HNSCC).

Methods: Univariate logistic regression and multivariate Cox regression analyses were performed on a retrospective cohort of 123 patients treated with primary chemoradiotherapy.

Results: The NLR is an indicator of both recurrence-free and overall survival, but the NLR does not have independent prognostic significance when the favorable prognostic influence of human papillomavirus (HPV) status is incorporated into multivariate models.

Conclusion: The interaction between NLR and HPV status suggests that HPV status may be a determining factor in the favorable prognosis associated with a decreased NLR in HNSCC; these findings also suggest that HPV status may interact with the prognostic associations of indicators of systemic inflammation in HNSCC. © 2017 Wiley Periodicals, Inc. Head Neck 39: 662-667, 2017.

Keywords: head and neck squamous cell carcinoma; human papillomavirus (HPV); inflammatory markers; neutrophil-to-lymphocyte ratio; prognosis.

MeSH terms

Aged
Analysis of Variance
Biomarkers, Tumor / blood*
Carcinoma, Squamous Cell / blood*
Carcinoma, Squamous Cell / mortality*
Carcinoma, Squamous Cell / pathology
Carcinoma, Squamous Cell / therapy
Cohort Studies
Combined Modality Therapy
Databases, Factual
Disease-Free Survival
Female
Head and Neck Neoplasms / blood*
Head and Neck Neoplasms / mortality*
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / therapy
Humans
Logistic Models
Lymphocyte Count
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local / mortality*
Neoplasm Recurrence, Local / pathology
Neoplasm Recurrence, Local / therapy
Neutrophils / metabolism
Prognosis
Proportional Hazards Models
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck
Survival Analysis

Substances

Biomarkers, Tumor