Prognostic value of inflammatory biomarkers in aged patients with oral squamous cell carcinoma

Takuya Yoshimura; Hajime Suzuki; Hirotaka Takayama; Shotaro Higashi; Yuka Hirano; Masahiro Tezuka; Takayuki Ishida; Kiyohide Ishihata; Marie Amitani; Haruka Amitani; Yasuhiro Nishi; Yasunori Nakamura; Yasushi Imamura; Etsuro Nozoe; Akio Inui; Norifumi Nakamura

doi:10.3389/fphar.2022.996757

Prognostic value of inflammatory biomarkers in aged patients with oral squamous cell carcinoma

Front Pharmacol. 2022 Nov 21:13:996757. doi: 10.3389/fphar.2022.996757. eCollection 2022.

Authors

Takuya Yoshimura¹, Hajime Suzuki¹, Hirotaka Takayama¹, Shotaro Higashi¹, Yuka Hirano¹, Masahiro Tezuka¹, Takayuki Ishida¹, Kiyohide Ishihata¹, Marie Amitani^{2

3}, Haruka Amitani³, Yasuhiro Nishi⁴, Yasunori Nakamura⁵, Yasushi Imamura⁶, Etsuro Nozoe¹, Akio Inui⁷, Norifumi Nakamura¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
² Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
³ Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
⁴ Department of Oral and Maxillofacial Prosthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
⁵ Department of Oral Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima, Japan.
⁶ Department of Internal Medicine, Kagoshima Kouseiren Hospital, Kagoshima, Japan.
⁷ Pharmacological Department of Herbal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Abstract

Background: Better prognostic biomarkers for oral squamous cell carcinoma (OSCC) must be developed, particularly within the realm of clinically and frequently administered tests, to advise appropriate clinical therapy and follow-up. In this study, we retrospectively investigated which of the several inflammation-nutrition indicators might predict the prognosis of patients with OSCC. Methods: The preoperative neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), CRP-albumin ratio (CAR), Glasgow prognostic score (GPS), modified GPS (mGPS), prognostic nutritional index (PNI), controlling nutrition status (CONUT), and modified CONUT (mCONUT) were retrospectively evaluated using blood samples collected 1-5 days before surgery. To estimate the effect on the prognosis of tumor progression, the mean values of the markers between stages I/II and III/IV were used for subgroup analysis. The multivariate Cox proportional hazards model included all independent variables significantly associated with survival in the univariate analysis to determine the independent variables. Results: A total of 112 patients (69 males and 43 females) with primary OSCC who underwent surgical treatment at our hospital were included. There were statistically significant differences in the mean values of monocytes, platelets, and albumin between stages I/II and III/IV. According to the multivariate Cox proportional hazards regression, a low PNI was associated with shorter overall survival (OS) and disease-free survival (DFS); women were associated with shorter DFS. Conclusion: The pretreatment PNI had excellent predictive value for the 5-year OS and DFS of patients with OSCC. Future large-scale prospective studies with a high sample size are needed to verify our findings in OSCC patients.

Keywords: frailty; inflammatory biomarkers; nutrition; oral squamos cell carcinoma; sarcopenia.