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Updated: May 4, 2026

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Systemic inflammatory markers as independent prognosticators of head and neck squamous cell carcinoma
Alipasha Rassouli1, Joe Saliba, Roberto Castano
1Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Background:
The purpose of this study was to investigate the prognostic value of the pretreatment inflammatory markers platelet-to-lymphocyte ratio (PLR) and the neutrophil-to-lymphocyte ratio (NLR) in patients with head and neck squamous cell carcinoma (HNSCC).
Methods:
We conducted a retrospective analysis of patients diagnosed with HNSCC at McGill University Health Center from 2000 to 2011 (273 patients were retained). Hematologic parameters were recorded within 4 weeks of diagnosis. Mortality and recurrence rates were compared according to various PLR and NLR thresholds.
Results:
Of the total patients, 20.5% died and 11.0% had disease recurrence. PLR >170 was associated with higher mortality (p = .008). The subgroup with a combination of PLR >170 and NLR ≤3.0 was associated with higher T classification and highest mortality (43%). NLR above 4.2 predicted higher rates of recurrence (p < .0001). The NLR/PLR combination was at least as good as TNM staging in predicting survival.
Conclusion:
PLR is an independent predictor of mortality; NLR is an independent predictor of recurrence in HNSCC. These parameters might be used to identify advanced stages rapidly and economically.
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