Multivariate analysis of prognostic factors in patients with lip squamous cell carcinoma after surgery

Abstract

Abstract Background: Lip squamous cell carcinoma (LSCC) was one of the most common cancer types of head and neck tumors. This study aimed to reveal clinical factors affecting the prognosis of postoperative LSCC patients. Methods: A total of 147 LSCC patients between June 2012 and June 2018 were collected and analyzed. There were 23 clinicopathological factors included in our study: age at diagnosis, gender, tumor location, pathological differentiation, American Joint Committee on Cancer (AJCC) stage, adjuvant chemotherapy, adjuvant radiotherapy, surgical margin, perineural invasion, extranodal extension (ENE), vascular invasion (VI), multiple primary tumors, age-adjusted Charlson comorbidity index (ACCI); body mass index (BMI), Glasgow prognostic Score (GPS), interquartile range (IQR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutrition index (PNI), eastern cooperative oncology group (ECOG) performance status (PS) score, systemic immune-inflammation index(SII), overall survival (OS), and progression-free survival (PFS). The univariate and multivariate Cox regression analyses were applied to reveal the independent prognostic factors in postoperative LSCC patients on PFS and OS. The benefit of adjuvant radiotherapy in various subgroups was also displayed by Kaplan-Meier curves. Results: In postoperative LSCC patients, the 1-, 3- and 5-year PFS were 88.4%, 70.1%, and 57.8%, and the 1-, 3- and 5-year OS were 94.6%, 76.9%, and 69.4%, respectively. The analysis results indicated that age ≥ 70 years, later stage, surgical margin <5mm, higher PNI, and ACCI ≥5 indicate poorer PFS in postoperative LSCC patients (All P<0.05). Besides, postoperative LSCC patients with age ≥ 70 years, later stage, surgical margin < 5mm, higher GPS score, higher SII, and ACCI ≥5 tend to have a poorer OS (All P<0.05). Additionally, postoperative LSCC patients with ACCI < 5 and AJCC III-IV stage were more likely to benefit from adjuvant radiotherapy, but not for the other subgroups. Conclusion: Our results showed that clinicopathological factors like age ≥ 70 years, close surgical margin, later stage, surgical margin < 5mm, higher PNI, higher GPS score, higher SII, and ACCI ≥5 had a great negative effect on the prognosis of postoperative LSCC patients. Postoperative LSCC patients with stage III-IV and ACCI < 5 can benefit from adjuvant radiotherapy.