Is Preoperative Plate-Lymphocyte Ratio a Predictor of Deep Vein Thrombosis in Patients With Oral Cancer During Surgery?

Kenji Yamagata; Satoshi Fukuzawa; Fumihiko Uchida; Naomi Ishibashi-Kanno; Toru Yanagawa; Hiroki Bukawa

doi:10.1016/j.joms.2020.10.024

Is Preoperative Plate-Lymphocyte Ratio a Predictor of Deep Vein Thrombosis in Patients With Oral Cancer During Surgery?

J Oral Maxillofac Surg. 2021 Apr;79(4):914-924. doi: 10.1016/j.joms.2020.10.024. Epub 2020 Oct 17.

Authors

Kenji Yamagata¹, Satoshi Fukuzawa², Fumihiko Uchida², Naomi Ishibashi-Kanno², Toru Yanagawa³, Hiroki Bukawa³

Affiliations

¹ Associate Professor, Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: y-kenji@md.tsukuba.ac.jp.
² Assistant Professor, Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
³ Professor, Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

PMID: 33197415
DOI: 10.1016/j.joms.2020.10.024

Abstract

Purpose: Detecting deep vein thrombosis (DVT) is necessary to reduce the morbidity of venous thromboembolism, and platelet-lymphocyte ratio (PLR) is a novel marker for predicting DVT. This study aimed to investigate the association between preoperative PLR and risk of developing DVT in patients receiving surgical treatment of oral cancer.

Patients and methods: We designed a retrospective cohort study, and the source of study sample was patients with oral cancer and who underwent surgery between 2015 and 2019. Patients were excluded if they did not undergo surgical treatment and had preoperative DVT and history of hypercoagulable disorders. The primary predictor variable was PLR. We calculated the receiver operating characteristic curve and area under the curve to determine the best-defined risk groups. The best cutoff value for PLR was 187.4 (area under the curve, 0.772; sensitivity, 75.0%; specificity, 74.2%; P = .002). The primary outcome variable was DVT, and the other variables were patient characteristics, blood examination data, and therapeutic data. A logistic regression analysis was used to adjust the effects of potential confounders.

Results: A total of 101 patients were included in this study, and DVT was observed in 12 (11.9%) patients. Free flap reconstructive surgery was performed in 8 of the 12 (66.7%) patients in the DVT group. Statistical analyses showed that DVT was significantly associated with PLR (≤187.4 vs >187.4; P = .001). Logistic multivariate analysis of the preoperative parameters identified the following 2 independent predictive factors for DVT: PLR (≤187.4 vs >187.4) (odds ratio, 13.735; 95% confidence interval, 2.950 to 63.944; P = .001) and free flap reconstructive surgery (odds ratio, 6.584; 95% confidence interval, 1.504 to 28.822; P = .012).

Conclusions: High PLR (>187.4) and free flap reconstructive surgery, considered as preoperative predictive factors, were associated with DVT.

MeSH terms

Humans
Lymphocytes
Mouth Neoplasms* / surgery
Retrospective Studies
Venous Thromboembolism*
Venous Thrombosis* / etiology