Sweet Ping Ng1,2, Houda Bahig3,4, Amit Jethanandani3, Erich M Sturgis5, Faye M Johnson6, Baher Elgohari3, G Brandon Gunn3, Renata Ferrarotto6, Jack Phan3, David I Rosenthal3, Steven J Frank3, Clifton D Fuller3, Adam S Garden7. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. sweetping.ng@gmail.com. 2. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. sweetping.ng@gmail.com. 3. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada. 5. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 6. Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 7. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. agarden@mdanderson.org.
Abstract
BACKGROUND: This study aimed to evaluate the prognostic value of pre-treatment NLR in patients with oropharyngeal cancer. METHODS: Patients who completed definitive radiotherapy (RT) for oropharyngeal cancer and had blood counts taken pre-RT from 2002 to 2013 were included. NLR was calculated as total neutrophil/lymphocytes. Survival rates were estimated using the Kaplan-Meier method. Univariable and multivariable analyses were conducted with linear and Cox regression methods. NLR was analysed posteriori and dichotomised on the discovered median. RESULTS: Eight hundred and forty-eight patients were analysed. The median pre-RT NLR was 3. Patients with NLR of <3 had improved overall survival (OS) than those with NLR ≥ 3 (5-year OS 85 vs 74%, p < 0.0001). OS differences remained significant when stratified according to HPV status (HPV-positive p = 0.011; HPV-negative p = 0.003). Freedom from any recurrence (FFR), locoregional control (LRC) and freedom of distant recurrence (FDR) were better in those with NLR < 3. The negative impact of elevated pre-RT NLR on OS (HR = 1.64, p = 0.001), FFR (HR = 1.6, p = 0.006) and LRC (HR = 1.8, p = 0.005) remained significant on multivariable analysis. CONCLUSIONS: Pre-RT NLR is an independent prognostic factor in patients with oropharyngeal cancer regardless of HPV status. Patients with lower NLR had more favourable OS and disease control.
BACKGROUND: This study aimed to evaluate the prognostic value of pre-treatment NLR in patients with oropharyngeal cancer. METHODS: Patients who completed definitive radiotherapy (RT) for oropharyngeal cancer and had blood counts taken pre-RT from 2002 to 2013 were included. NLR was calculated as total neutrophil/lymphocytes. Survival rates were estimated using the Kaplan-Meier method. Univariable and multivariable analyses were conducted with linear and Cox regression methods. NLR was analysed posteriori and dichotomised on the discovered median. RESULTS: Eight hundred and forty-eight patients were analysed. The median pre-RT NLR was 3. Patients with NLR of <3 had improved overall survival (OS) than those with NLR ≥ 3 (5-year OS 85 vs 74%, p < 0.0001). OS differences remained significant when stratified according to HPV status (HPV-positive p = 0.011; HPV-negative p = 0.003). Freedom from any recurrence (FFR), locoregional control (LRC) and freedom of distant recurrence (FDR) were better in those with NLR < 3. The negative impact of elevated pre-RT NLR on OS (HR = 1.64, p = 0.001), FFR (HR = 1.6, p = 0.006) and LRC (HR = 1.8, p = 0.005) remained significant on multivariable analysis. CONCLUSIONS: Pre-RT NLR is an independent prognostic factor in patients with oropharyngeal cancer regardless of HPV status. Patients with lower NLR had more favourable OS and disease control.
Authors: James M Price; Hitesh B Mistry; Guy Betts; Eleanor J Cheadle; Lynne Dixon; Kate Garcez; Tim Illidge; Zsuzsanna Iyizoba-Ebozue; Lip Wai Lee; Andrew McPartlin; Robin J D Prestwich; Savvas Papageorgiou; Dylan J Pritchard; Andrew Sykes; Catharine M West; David J Thomson Journal: J Clin Oncol Date: 2022-04-06 Impact factor: 50.717
Authors: Sung Jun Ma; Han Yu; Michael Khan; Jasmin Gill; Sharon Santhosh; Udit Chatterjee; Austin Iovoli; Mark Farrugia; Hemn Mohammadpour; Kimberly Wooten; Vishal Gupta; Ryan McSpadden; Moni A Kuriakose; Michael R Markiewicz; Wesley L Hicks; Mary E Platek; Mukund Seshadri; Andrew D Ray; Elizabeth Repasky; Anurag K Singh Journal: JAMA Netw Open Date: 2022-04-01