The neutrophil-to-lymphocyte ratio (NLR), a marker of the systemic inflammatory response, has been reported to have prognostic value in different cancer settings. In this study we aimed to assess the prognostic impact of NLR in a cohort of patients with head and neck cancers.
Patients with head and neck cancer treated with concurrent chemo-radiotherapy (Cisplatin) between 01/2013 and 12/2015 were included in this study. NLR was analyzed as a continuous variable and as dichotomous variable (≤ 5 vs. > 5). The primary end point was overall survival (OS). Progression free survival (PFS) was the secondary endpoint. Univariate analysis was used to identify associations and to select variables included in multivariate Cox regression analysis to determine prognostic value.
146 patients (132 squamous cell carcinomas (SCC), 10 undifferencied nasopharyngeal carcinomas (UCNT) and 4 neuroendocrine carcinomas) were included in this analysis. The median follow up was 20.6 months (2.4-37.0 months). 1-year and 2-year OS were 87.1% and 82.3%, respectively.1-year and 2-year PFS were 75.9% and 68.0%, respectively. On univariate analysis, OS significantly differed between groups NLR ≤ 5 vs. > 5. In the overall population (OP) (HR: 2.6; IC95%: [1,05-6,53]; p = 0036) and in non-oropharyngeal subpopulation (HR: 3.67; IC95%: [1,19-11,4]; p = 0,016) but not in the oropharyngeal subpopulation (p = 0,51). In multivariate analysis NLR >5 was significantly associated with a poorer OS in the OP (HR: 2.89; IC95%: [1,14-7,33]; p = 0.025) and in non-oropharyngeal subpopulation (HR: 4.53; IC95%: [1,34-13,5]; p = 0.014). Body Mass Index (BMI)
In this cohort of patients treated with chemo-radiotherapy for head and neck cancer, pre-treatment NLR >5 was predictive of shorter overall survival. Further prospective clinical investigations are required to confirm these results and determine the clinical applicability as prognostic factor.
Clinical trial identification
Legal entity responsible for the study
Centre Oscar Lambret
All authors have declared no conflicts of interest.