Systemic inflammatory response and survival in patients undergoing curative resection of oral squamous cell carcinoma

Prognostic stratification in squamous cell carcinoma (SCC) of the head and neck has traditionally relied on the pathological staging of a tumour, but it is increasingly being recognised that host-related factors have an important role in the assessment of survival and recurrence. We aimed to evaluate the prognostic value of systemic inflammation scores including the modified Glasgow Prognostic Score (mGPS) in patients undergoing potentially curative resection for oral SCC. We retrospectively identified 178 patients who had curative operations for cancer of the oral cavity and soft palate between January 2006 and April 2011. Among the inclusion criteria were preoperative estimates of C-reactive protein and serum albumin. We analysed established pathological prognostic factors and scores for systemic inflammation as predictors of cancer-specific and overall survival. On univariate analysis, the mGPS was a significant predictor of both cancer-specific (p<0.001) and overall survival (p<0.001), and it remained an independent predictor of cancer-specific (HR: 2.12, 95% CI 1.49 to 3.00; p<0.001) and overall survival (HR: 1.69, 95% CI 1.23 to 2.31; p=0.001) on Cox regression analysis. The mGPS of activated systemic inflammation seems to be a powerful adverse prognostic indicator in resectable oral SCC.