Prognostic value of systemic inflammatory markers in head and neck squamous cell carcinoma

This study aimed to estimate the prognostic value of the inflammatory indexes (NLR, PLR, LMR, SII, and SIM) in the prognosis of patients with HNSCC.

We retrospectively studied 396 patients with HNSCC diagnosed and managed over the last decade in the First Otolaryngology department of Hippokrateion hospital. The inflammatory marker counts were obtained from the pre-operative blood tests, and the survival data were recorded through the patients' follow-up. The Kaplan-Meier method, the Cox proportional hazards model, and the receiver operating characteristics (ROC) curve were used to determine the prognostic values of the inflammatory markers and other factors.

Factors found to be significantly associated with both DFS and OS were higher body mass index (BMI), tumor location, cancer stage (patients with advanced cancer stage reported lower DFS and OS), primary treatment, ECOGI PS scale and Charlson Index. Inflammatory marker PLR was found to be a significant predictor in both DFS (HR = 1.329; 95% CI = 1.041, 1.697) and OS (HR = 1.398; 95% CI = 1.073, 1.823), indicating that patients with higher PLR (cut off equal to 155) have a higher hazard of death. The same findings were present for SII regarding DFS (HR = 1.280; 95%CI = 1.013, 1.618), whereas the HR regarding OS was borderline but non-significant (HR = 1.168; 95%CI = 0.895, 1.525).

Platelet-based inflammation markers were qualified as novel and independent prognostic factors, and they could be useful biomarkers for predicting survival outcomes in patients with HNSCC.