The H-index in patients undergoing upfront surgery and free flap reconstruction for head and neck squamous cell carcinoma.| ACTA Otorhinolaryngologica Italica

Abstract

Objective: The Host-index (H-index) is a value obtained using laboratory parameters. Elevated H-index is a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC) patients. The purpose of our study was to assess the prognostic impact of the H-Index in patients with locally advanced tumors who underwent reconstructive surgery with free flaps.

Methods: We performed a retrospective study on a cohort of patients referred to our center from January 2013 to October 2018. We assessed the prognostic role of H-index in terms of disease-free (DFS) and overall survival (OS).

Results: A total of 99 patients were studied, with a median age of 66 years. With a median follow-up of 46.5 months (range:1.4- 121.9), 5-year OS was 59.6% (CI 29.3-57.5) and 5-year DFS 47.5% (CI 16.7-49.2). The H-index showed a statistically significant correlation with a shorter DFS (HR 1.2, 95% CI 1.1-1.4, p=0.006). No correlations were found between surgical complications and the H-index.

Conclusions: This study confirmed H-index as an independent prognostic value for DFS in HNSCC patients undergoing microvascular reconstructive surgery and should be used to better stratify the risk of mortality and recurrence, with the aim of improving HNSCC patient management.