Prognostic Value of Pre-Treatment Neutrophil-to-Lymphocyte Ratio and Platelet in Patients with Operable Head and Neck Squamous Cell Carcinoma

Abstract

Background: Peripheral blood inflammation factor neutrophil-lymphocyte Ratio (NLR), platelet and nutritional factor albumin (ALB) have recently been proposed as prognostic markers in solid tumors. The current study the impact of those hematological parameters and oncologic outcomes in patients with operable head and neck squamous carcinoma cancer (HNSCC) using database approach were evaluated. Methods: 198 patients with oropharyngeal, hypopharyngeal and laryngeal cancers receiving multimodality protocols between 2012 and 2014 were included. Neutrophil, lymphocyte, platelet and albumin from the last phlebotomy before treatment were identified. Patients were risk-stratified and were tested for association with survival and disease-control outcomes. Results: 5-year LRC were decreased (p=0.004, respectively) for 140 patients with NLRpre-treatment 248×109/L were better among tested models. On Bayesian information criteria (BIC) analysis, the optimal prognostic model was then used to develop nomograms predicting 3- and 5-year locoregional recurrence (LRC). External validity evaluated by studying another 57 patients from other hospital confirmed the reliability of prediction model. Conclusion: Pre-treatment NLR elevation and platelet >248×109/L are promising predictors of prognosis in patients with operable HNSCC. The analyses performed show that pre-treatment hematological inflammatory markers and platelet-based Nomograms provide a distinct risk stratification. Further works should be complete to elucidate the utility of anti-inflammatory and anti- platelet treatments in modifying risk in peri-operation HNSCC patients. Funding Statement: This study is sponsored by grants from Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (Grant No.2019336033). Medical Health Science Project of Hangzhou (Grant No. OO20190775). Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: This study was in accordance with Declaration of Helsinki and approved by the Research Ethic Committees of Affiliated Sir Run Run Shaw Hospital, Zhejiang University medical college and The Second Affiliated Hospital of Nanchang University Medical College. Both the institutional review board approved data extraction was performed from an existing HNSCC.