Prognostic role of neutrophil‐to‐lymphocyte ratio in head and neck cancer: A meta‐analysis

Takenaka, Yukinori; Oya, Ryohei; Kitamiura, Takahiro; Ashida, Noboru; Shimizu, Ken D.; Takemura, Kazuya; Yamamoto, Yoshihiko; Uno, Atsuhiko

doi:10.1002/hed.24986

Cited by 107 publications

(110 citation statements)

References 61 publications

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“…However, HCC is generally accompanied by liver cirrhosis, which eventually causes thrombocytopenia. Other researchers and we performed a meta-analysis regarding the association between HNSCC and platelet count and PLR in the present study, as well as between HNSCC and NLR 47 and nasopharyngeal carcinoma and NLR, PLR, and LMR. 65 In this study, we focused on the effect of platelet count and PLR on HNSCC.…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, blood markers are not affected by any heterogeneity within the tumor. Although 2 meta-analyses regarding the association between HNSCC prognosis and the neutrophil-lymphocyte ratio (NLR) have been published recently, 47,48 no meta-analyses on the association between HNSCC prognosis and platelet count or PLR have been reported. 14 Platelet count and plateletlymphocyte ratio (PLR) are hematologic makers that have shown prognostic abilities across many types of cancers.…”

Section: Introductionmentioning

confidence: 99%

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Platelet count and platelet‐lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta‐analysis

et al. 2018

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Platelet count and platelet‐lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta‐analysis

et al. 2018

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“…The most analyzed parameters in the literature are the pretreatment absolute count of neutrophils, monocytes, and lymphocytes, as well as the ratio between neutrophils and lymphocytes (neutrophil‐to‐lymphocyte ratio; NLR). These have been reported to be strong predictors of outcomes in a wide range of tumor models, including head and neck tumors . Moreover, to integrate the influence of all these variables, Qi et al have recently proposed an index called Systemic Inflammation Response Index (SIRI), which combines all the leukocytes of interest (neutrophils, monocytes, and lymphocytes), showing that it has prognostic capacity in pancreatic cancer …”

Section: Introductionmentioning

confidence: 99%

“…These have been reported to be strong predictors of outcomes in a wide range of tumor models, including head and neck tumors. [9][10][11][12][13][14][15][16][17][18][19][20] Moreover, to integrate the influence of all these variables, Qi et al have recently proposed an index called Systemic Inflammation Response Index (SIRI), which combines all the leukocytes of interest (neutrophils, monocytes, and lymphocytes), showing that it has prognostic capacity in pancreatic cancer. 21 Multiple studies have been published analyzing the prognostic capacity of pretreatment peripheral blood leukocytes (PBLs) using different cutoffs found using different methods.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment peripheral blood leukocytes are independent predictors of survival in oral cavity cancer

Valero

Zanoni

McGill

et al. 2019

Cancer

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Background Inflammation and immune surveillance evasion are cancer hallmarks. Peripheral blood leukocytes (PBLs) represent both. The aim of the current study was to examine PBLs as predictors of outcomes in oral cavity squamous cell carcinoma (OSCC), and to find specific cutoffs with the goal of including PBLs as host factor in patients' preoperative risk assessment. Methods Previously established head and neck squamous cell carcinoma (HNSCC) cutoffs were examined in an independent cohort of 1369 OSCC patients. Then optimal OSCC cutoffs were found and validated in the subset of patients with OSCC (n = 119) from the external HNSCC cohort. The PBLs analyzed were neutrophils, monocytes, and lymphocytes individually, the neutrophil‐to‐lymphocyte ratio (NLR), and a combined index using all PBLs called Systemic Inflammation Response Index (SIRI). Results All parameters were significant predictors of survival using the previous cutoffs. However, OSCC cutoffs stratified survival outcomes better. Considering neutrophils ≤4.8 × 109/L as reference, patients with 4.8–9.1 × 109/L neutrophils had 1.536 times higher risk of death (95% CI, 1.295‐1.822), and patients with ≥9.1 × 109/L had 3.076 times higher risk (95% CI: 2.170‐4.360). All PBLs maintained independent prognostic capacity in multivariable analysis. Neutrophils, NLR, and SIRI were significant predictors of survival when validating OSCC cutoffs in the external validation cohort. Conclusions Pretreatment peripheral blood neutrophils, NLR, and SIRI are the most robust independent predictors of overall survival among all PBLs in OSCC. The authors report externally validated cutoffs that demonstrate the feasibility of including PBLs as host features in the preoperative prognostication of OSCC.

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“…Enhancement of neutrophil infiltration by tumor cells has been reported to promote tumor growth and progression through remodeling of the extracellular matrix and activation of inflammatory markers, whereas lymphocyte infiltration is thought to be associated with control of cancer progression, especially when T4 helper and T8 suppressor lymphocytes are involved . Not surprisingly, a high NLR has been shown to be a significant predictive factor for survival in patients with cancer, including solid neoplasms such as head and neck cancer …”

Section: Discussionmentioning

confidence: 99%

Anemia and neutrophil‐to‐lymphocyte ratio in laryngeal cancer treated with induction chemotherapy

et al. 2019

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Objectives/Hypothesis We studied the influence of the neutrophil‐to‐lymphocyte ratio (NLR) and anemia on the response to induction chemotherapy (IC) and survival outcomes in laryngeal cancer patients treated with a preservation protocol. Study Design Retrospective single‐center case series. Methods We analyzed patients with T3 laryngeal cancer treated with IC using a preservation protocol. The NLR and hemoglobin levels were assessed before treatment and after IC. The response to chemotherapy was assessed using Response Evaluation Criteria in Solid Tumours 1.1 and World Heath Organization standards. The oncological endpoints were overall survival (OS) and disease‐free survival (DFS). Results Sixty‐eight patients were analyzed. The median NLR and hemoglobin levels before and after IC were 2.76 and 14.5 g/dL, and 2.01 and 11.6 g/dL, respectively. The NLR and anemia before treatment were not correlated, and they were not associated with the response to chemotherapy. However, an NLR > 5 and anemia before treatment were both associated with shorter OS and DFS. Notably, they were the only factors found to be significantly associated with survival outcomes. Conclusions In laryngeal cancer, patients treated with a preservation protocol, a high NLR ratio, and anemia before IC were associated with shorter survival, independently of the response to chemotherapy. Level of Evidence 4 Laryngoscope, 130:E144–E150, 2020

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Prognostic role of neutrophil‐to‐lymphocyte ratio in head and neck cancer: A meta‐analysis

Abstract: Elevated NLR predicts worse outcomes in patients with HNSCC.

Cited by 107 publications

References 61 publications

Platelet count and platelet‐lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta‐analysis

Platelet count and platelet‐lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta‐analysis

Pretreatment peripheral blood leukocytes are independent predictors of survival in oral cavity cancer

Anemia and neutrophil‐to‐lymphocyte ratio in laryngeal cancer treated with induction chemotherapy

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