Abstract
Objective: The neutrophil-to-lymphocyte ratio (NLR) has been reported to be associated with survival in solid malignancies. The main goal was to evaluate the prognostic significance of the NLR in patients with p16-negative squamous cell carcinoma of unknown primary (SCCUP) in head and neck.Methods: The association between the NLR and clinical pathologic variables was evaluated by the chi-square test. The primary endpoint of interest was disease-specific survival (DSS). Univariate and Coxmodel analyses were used to evaluate prognostic factors.Results: A total of 153 patients were included in the analysis. Cancer cachexia was noted in 10 patients. The mean NLR value was 3.9 (range: 1.4–8.3). A high NLR was significantly associated with cancer cachexia development. The 5-year DSS rate was 58%. In patients with NLRs varying from 1.4 to 3.7, the 5-year DSS rate was 71%; in patients with NLRs varying from 3.7 to 6.0, the 5-year DSS rate was 57%; in patients with NLRs varying from 6.0 to 8.3, the 5-year DSS rate was 39%, and the difference was significant (p = 0.001). Further Cox model analysis confirmed the independence of the NLR in predicting survival.Conclusions: In patients with p16-negative SCCUP, an NLR ≥ 6.0 is significantly associated with worse prognosis.
Highlights
Squamous cell carcinoma (SCC) of the head and neck (SCCHN) is one of the relatively uncommon malignant epithelial tumors in the body and usually has neck lymph node metastasis at initial diagnosis
Sex, node stage based on the AJCC 7th system, the neutrophil-to-lymphocyte ratio (NLR), operation record, pathology record, and follow-up were extracted and analyzed
Cancer cachexia was noted in 10 patients
Summary
Squamous cell carcinoma (SCC) of the head and neck (SCCHN) is one of the relatively uncommon malignant epithelial tumors in the body and usually has neck lymph node metastasis at initial diagnosis. In the clinic, ∼1–4% of metastatic nodes can occur without any evidence of primary disease even after a clinical examination by a head and neck specialist, cytology and biopsy, Significance of the Neutrophil-to-Lymphocyte Ratio endoscopy and radiological investigations including ultrasound, CT, MRI, and PET/CT [1]. These lesions could be divided into two groups based on the result of immunohistochemical analysis of p16, p16-negative patients with squamous cell carcinoma of unknown primary (SCCUP) are more common and have significantly different survival compared with p16-positive patients [2, 3]. The main goal of the current study was to clarify these questions
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