Wu-Chia Lo1,2, Chen-Tu Wu1,3, Cheng-Ping Wang1,4, Tsung-Lin Yang4, Pei-Jen Lou4, Jeng-Yuh Ko4, Yih-Leong Chang5,6. 1. Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan. 2. Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan. 3. Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 4. Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. 5. Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan. ntuhylc@gmail.com. 6. Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. ntuhylc@gmail.com.
Abstract
OBJECTIVE: This study aimed to investigate the clinicopathological factors that influence recurrence and survival in patients who undergo operations for T3-4 hypopharyngeal squamous cell carcinomas (SCCs). MATERIALS AND METHODS: One hundred and five patients who underwent surgery between 2001 and 2008 for advanced hypopharyngeal SCCs were consecutively enrolled and reviewed. RESULTS: The pretreatment neutrophil-to-lymphocyte ratio (NLR; median 3.22, range 0.62-46.50) was associated with disease recurrence and patient survival. A difference in the 5-year cumulative disease recurrence rate between patients with high (≥3.22) and low (<3.22) NLRs was significant (60.4 and 36.5%, respectively; p = 0.004). A multivariate analysis confirmed that an NLR ≥3.22 was an independent indicator of a poor prognosis for advanced hypopharyngeal SCC, as per the following parameters: overall survival (hazard ratio [HR] 2.53, 95% confidence interval [CI] 1.48-4.30, p = 0.001), disease-specific survival (HR 2.45, 95% CI 1.38-4.34, p = 0.002), and disease-free survival (HR 2.18, 95% CI 1.24-3.83, p = 0.007). Additional prognostic factors per the survival analyses included lymph node density, surgical margin, lymphovascular invasion, and perineural invasion. CONCLUSIONS: An NLR ≥3.22 is associated with a higher risk of disease recurrence and poor survival in patients with T3-4 hypopharyngeal SCCs. We propose the use of the NLR to broaden the current TNM staging system; the development of a more effective treatment protocol for patients with high NLRs will be essential.
OBJECTIVE: This study aimed to investigate the clinicopathological factors that influence recurrence and survival in patients who undergo operations for T3-4 hypopharyngeal squamous cell carcinomas (SCCs). MATERIALS AND METHODS: One hundred and five patients who underwent surgery between 2001 and 2008 for advanced hypopharyngeal SCCs were consecutively enrolled and reviewed. RESULTS: The pretreatment neutrophil-to-lymphocyte ratio (NLR; median 3.22, range 0.62-46.50) was associated with disease recurrence and patient survival. A difference in the 5-year cumulative disease recurrence rate between patients with high (≥3.22) and low (<3.22) NLRs was significant (60.4 and 36.5%, respectively; p = 0.004). A multivariate analysis confirmed that an NLR ≥3.22 was an independent indicator of a poor prognosis for advanced hypopharyngeal SCC, as per the following parameters: overall survival (hazard ratio [HR] 2.53, 95% confidence interval [CI] 1.48-4.30, p = 0.001), disease-specific survival (HR 2.45, 95% CI 1.38-4.34, p = 0.002), and disease-free survival (HR 2.18, 95% CI 1.24-3.83, p = 0.007). Additional prognostic factors per the survival analyses included lymph node density, surgical margin, lymphovascular invasion, and perineural invasion. CONCLUSIONS: An NLR ≥3.22 is associated with a higher risk of disease recurrence and poor survival in patients with T3-4 hypopharyngeal SCCs. We propose the use of the NLR to broaden the current TNM staging system; the development of a more effective treatment protocol for patients with high NLRs will be essential.
Authors: Pierluigi Mariani; Diana Russo; Marco Maisto; Giuseppe Troiano; Vito Carlo Alberto Caponio; Marco Annunziata; Luigi Laino Journal: J Oral Pathol Med Date: 2021-12-09 Impact factor: 3.539