Prognostic value of preoperative inflammatory ratios in early glottic cancer treated with transoral laser surgery

Head Neck. 2024 Apr;46(4):819-830. doi: 10.1002/hed.27631. Epub 2024 Jan 9.

Abstract

Background: There is growing evidence regarding the prognostic utility of ratios such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SIII) in head and neck squamous cell carcinoma (HNSCC). However, most studies to date include heterogeneous series with different treatments or tumor subsites.

Methods: We collected data from 201 patients with stage I-II glottic squamous cell carcinoma treated with transoral laser surgery. NLR, PLR, and SIII were calculated from preoperative cell blood count, cut-off points were obtained by ROC curve analysis, and survival rates were calculated.

Results: High NLR (p = 0.012) and SIII (p = 0.037), but not PLR (p = 0.48), were associated with worse disease-specific survival (DSS). A similar trend was observed with overall survival (OS), although it did not reach statistical significance. On multivariable analyses, both high NLR (HR = 3.8, 95% CI = 1.5-9.9, p = 0.006) and high SIII (HR = 2.77, 95% CI = 1.1-6.9, p = 0.03) were significantly associated with shortened DSS.

Conclusions: Preoperative NLR and SIII emerge as independent prognostic biomarkers for early-stage surgically treated glottic tumors and could guide individualized follow-up.

Keywords: glottic cancer; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; prognostic score; systemic immune-inflammatory index.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Head and Neck Neoplasms* / pathology
  • Humans
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / surgery
  • Laser Therapy*
  • Lymphocytes / pathology
  • Neutrophils / pathology
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / surgery