Prognostic value of changes in pre- and post-surgery inflammatory blood markers in HPV-negative head and neck squamous cell carcinomas| ACTA Otorhinolaryngologica Italica

Abstract

Objective. Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are inflammatory markers easily obtained from a routine complete blood count, and their preoperative values have recently been correlated with oncological outcomes in patients with HPV-negative head and neck squamous cell carcinoma (HNSCC). The aim of this study is to evaluate the prognostic value of NRL and LMR before and after treatment in patients with HPV-negative HNSCC undergoing up-front surgical treatment.

Methods. This multicentric retrospective study was performed on a consecutive cohort of patients underwent upfront surgery for HPV-negative HNSCC between April 2004 and June 2018. Only patients whose pre- and post-operative NRL and LMR were available were included. Their association with local, regional and distant failure, progression-free survival (PFS) and overall survival (OS) was calculated.

Results. A total of 493 patients (mean age 68 years) were enrolled. The mean follow-up time was 54 months. Pre-surgical NLR ≥3.76 was associated with a high risk of regional failure (HR=2.21, 95% CI: 1.08-5.55), disease progression (HR=1.55, 95% CI: 1.07-2.25) and death (HR=1.40, 95% CI: 0.94-2.10). A post-surgical LMR <2.92 had a significant impact on disease progression (HR=1.92, 95% CI: 1.13-3.28) and OS (HR=2.98, 95% CI: 1.53-5.81). Patients with stable NLR≥3.76 in the pre- and post-operative period reported both worse OS and PFS.

Conclusions. Our results support that pre- and post-surgery NLR and LMR value can be useful in detecting patients at risk of local, regional or distant recurrence who may require closer follow-up or more aggressive treatment.