Neutrophil-to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma

Significance Statement

Biomarkers such as neutrophil and lymphocyte counts, neutrophil-to-lymphocyte ratio (NLR) have been proposed as potential prognostic factors for cancer. There is accumulating evidence for the association of NLR with survival of patients with many kinds of cancers. In order to obtain an objective and consistent conclusion, the authors conducted this comprehensive analysis of the association between NLR and survival of oral, pharyngeal, and laryngeal squamous cell carcinomas.

Journal Reference

Head Neck. 2015 . doi: 10.1002/hed.24159.

Rachidi S^1,2, Wallace K^2,3, Wrangle JM^1,4, Day TA^2,5, Alberg AJ^2,3, Li Z^1,2,4.

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Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina.
Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
Division of Hematology and Oncology-Department of Internal Medicine, Medical University of South Carolina, Charleston, South Carolina.
Head and Neck Tumor Center, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.

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Abstract

BACKGROUND:

Current prognostic criteria are insufficient in predicting outcomes in head and neck cancer, necessitating new, readily available biomarkers.

METHODS:

Pretreatment neutrophil and lymphocyte counts and their ratio (NLR) were retrospectively investigated for correlation with overall survival while controlling for demographic and clinical confounders.

RESULTS:

Patients in the highest tertile of neutrophil counts and those in the lowest tertile of lymphocytes experienced shorter survival than the rest of the population. Patients in the highest tertile of the neutrophil-to-lymphocyte ratio were at a higher risk compared with those in the lowest tertile after multivariate analysis (hazard ratio [HR] = 2.39; p = .0001). Additionally, NLR was lower in patients with human papillomavirus (HPV)-positive tumors compared to HPV-negative tumors and predicted survival in both tumor types.

CONCLUSION:

Neutrophil and lymphocyte counts are strong biomarkers with opposing prognostic significance and the NLR is a robust predictor of overall survival in oral, pharyngeal, and laryngeal squamous cell carcinomas. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

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