Prediction and Prognostication of Peripheral Blood Biomarkers in Head and Neck Cutaneous Squamous Cell Carcinoma

While many with head and neck cutaneous squamous cell carcinomas (cHNSCC) respond well to surgery alone, there is a need to refine traditional staging systems. We aim to identify whether peripheral blood biomarkers (PBBMs) may enhance current staging for prognostication and adjuvant treatment selection.

Retrospective cohort study.

Single, tertiary academic referral center.

Preoperative and postoperative PBBMs and patient/disease characteristics were collected for adults surgically treated for cHNSCC at an academic center from 2016 to 2022. Pearson correlations and t-tests were utilized to correlate PBBMs with tumor characteristics. Univariate and multivariate analysis was performed to correlate predictors with overall survival. Staging systems were compared using Kaplan-Meier regression and Chi-square test for trend and independence.

409 patients (median age 75.4, 77% male, 99% White, median follow-up 34.5 months) underwent surgical resection for cHNSCC between 2016 and 2022. While several preoperative PBBMs correlated with tumor size and nodal burden, none were found to predict OS. On univariate analysis, high postoperative relative neutrophils and platelet-to-lymphocyte ratio (PLR) were associated with worse OS. High relative lymphocytes, total albumin, and prognostic nutritional index (PNI) were associated with improved OS. On multivariate analysis, no PBBM was significant for predicting OS.

This is the first study to evaluate the prognostic value of PBBMs in cHNSCC. Preoperative PBBMs correlated with tumor size and nodal burden, while high CCI and low postoperative NLRs negatively predicted survival. Further prospective research is needed for validation.