Fa Chen1, Lisong Lin2, Lingjun Yan3, Yu Qiu2, Lin Cai4, Baochang He5. 1. Doctoral Candidate, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China. 2. Physician, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China. 3. Master Degree Candidate, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China. 4. Professor, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China. 5. Associate Professor, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China. Electronic address: prof_hbc@163.com.
Abstract
PURPOSE: To assess and determine the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: The prospective study involving 1,202 patients with OSCC and surgical resection was carried out in Fujian, China. Two-stage analyses were performed by randomly dividing all patients into 800 discovery and 402 replication sets. The optimal NLR cutoff points were identified by the X-tile program with minimum P values. Prognostic factors were evaluated using univariate and multivariate Cox regression models. RESULTS: The discovery set was categorized as low-, middle-, and high-risk groups based on optimal NLR cutoff points (<1.94, 1.94 to 3.66, and >3.66, respectively). A high NLR was meaningfully associated with an increased risk of death on survival (NLR 1.94 to 3.66, hazard ratio [HR] = 1.51; 95% confidence interval [CI], 1.09-2.08; NLR >3.66, HR = 1.76; 95% CI, 1.21-2.55). In the replication phase, patients with a high NLR showed considerably worse overall survival compared with those with a low NLR (NLR 1.94 to 3.66, HR = 1.61; 95% CI, 1.02-2.55; NLR >3.66, HR = 1.94; 95% CI, 1.16-3.27). In addition, better overall survival was observed for patients with a higher NLR who had received postoperative chemoradiotherapy (HR = 0.49; 95% CI, 0.26-0.92). CONCLUSION: The preoperative NLR is an independent factor in predicting the prognosis of OSCC, especially for patients with chemoradiotherapy, which could serve as a potential target for improving patients' prognosis.
PURPOSE: To assess and determine the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: The prospective study involving 1,202 patients with OSCC and surgical resection was carried out in Fujian, China. Two-stage analyses were performed by randomly dividing all patients into 800 discovery and 402 replication sets. The optimal NLR cutoff points were identified by the X-tile program with minimum P values. Prognostic factors were evaluated using univariate and multivariate Cox regression models. RESULTS: The discovery set was categorized as low-, middle-, and high-risk groups based on optimal NLR cutoff points (<1.94, 1.94 to 3.66, and >3.66, respectively). A high NLR was meaningfully associated with an increased risk of death on survival (NLR 1.94 to 3.66, hazard ratio [HR] = 1.51; 95% confidence interval [CI], 1.09-2.08; NLR >3.66, HR = 1.76; 95% CI, 1.21-2.55). In the replication phase, patients with a high NLR showed considerably worse overall survival compared with those with a low NLR (NLR 1.94 to 3.66, HR = 1.61; 95% CI, 1.02-2.55; NLR >3.66, HR = 1.94; 95% CI, 1.16-3.27). In addition, better overall survival was observed for patients with a higher NLR who had received postoperative chemoradiotherapy (HR = 0.49; 95% CI, 0.26-0.92). CONCLUSION: The preoperative NLR is an independent factor in predicting the prognosis of OSCC, especially for patients with chemoradiotherapy, which could serve as a potential target for improving patients' prognosis.