Predictive Value of Combined Peripheral Inflammatory Markers in Patients with Head and Neck Cancers

Abstract

AbstractBackground Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignancies worldwide, and patients have low survival and poor quality of life. Combined peripheral inflammatory markers are associated with poor outcomes in patients with malignancies. This study aimed to investigate the prognostic significance of combined peripheral inflammatory markers in patients with HNSCC. Methods Records of 531 patients with histologically confirmed HNSCC between January 2009 and January 2021 were reviewed. The optimal cutoff values of peripheral inflammatory markers were determined by the receiver operating characteristic curve analysis and the Youden test. The neutrophil-to-lymphocyte ratio (NLR)–platelet-to-lymphocyte ratio (PLR) score, NLR–monocyte-to-lymphocyte ratio (MLR) sore, and PLR-MLR score ranged from low to high, i.e., a high score indicated that both inflammation markers are high; mid score, either inflammation marker is high; and low score, both inflammation markers are low. The overall survival (OS) and disease-free survival (DFS) were evaluated. Univariate and multivariate analyses were performed. Results The median follow-up time was 55 (range, 3–148) months. The optimal cutoff values for pretreatment NLR, PLR, MLR, systemic inflammation response index (SIRI), and systemic immune inflammation index (SII) were 2.21, 214.24, 0.33, 0.86, and 472.44, respectively. Univariate analyses revealed that smoking status (P = 0.021), drinking status (P = 0.033), tumor stage (P < 0.001), nodal stage (P < 0.001), tumor node metastasis (TNM) stage (P < 0.001), SIRI (P = 0.031), NLR-PLR score (P = 0.007), NLR-MLR score (P = 0.004), and PLR-MLR score (P < 0.001) were significantly associated with OS. Independent prognostic factors for OS were smoking status, drinking status, tumor stage, and PLR-MLR score. Univariate analyses revealed that smoking status (P = 0.008), tumor stage (P < 0.001), nodal stage (P < 0.001), TNM stage (P < 0.001), SIRI (P = 0.003), SII (P = 0.010), NLR-PLR score (P = 0.002), NLR-MLR score (P = 0.002), and PLR-MLR score (P < 0.001) were significantly associated with DFS. Independent prognostic factors for DFS were smoking status and PLR-MLR score. Conclusions PLR-MLR score may be a valuable inflammatory marker for the prediction of survival in patients with HNSCC.