Prognostic value of pretreatment circulating neutrophils, monocytes, and lymphocytes in oropharyngeal cancer stratified by human papillomavirus status

Huang, Shao Hui; Waldron, John; Milosevic, Michael; Shen, Xiaowei; Ringash, Jolie; Su, Jie; Li, Tong; Perez-Ordonez, Bayardo; Weinreb, Ilan; Bayley, Andrew; Kim, John; Hope, Andrew; Cho, J.; Giuliani, Meredith; Razak, Albiruni Abdul; Goldstein, David P.; Shi, Willa; Liu, Fei‐Fei; Xu, Wei

doi:10.1002/cncr.29100

Cited by 145 publications

(191 citation statements)

References 46 publications

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“…Because high-dose radiation has been shown to alter cells associated with pro-and antitumour immunity 31 , investigating the interplay between dose and these cell ratios is also justified. Finally, cbc within 3 months of sbrt, as chosen for the present study, is consistent with other radiotherapy analyses of nlr and mlr 5,11 ; however, the degree to which neutrophils, monocytes, and lymphocytes can change within that time period is not known.…”

Section: Figure 2 Kaplan-meier Curves For Overall Survival By Neutropsupporting

confidence: 87%

“…Patients with clinical T1-2N0M0 nsclc who had received lung sbrt at our institution from January 2005 to January 2012 and who had cbc results within the 3 months before the start of sbrt were included 5,11 . Clinical and treatment data were abstracted from a prospective database that contains information on patient demographics, treatment, toxicities, patterns of recurrence, and cause of death.…”

Section: Patient Selectionmentioning

confidence: 99%

“…In a 2015 study of pre-treatment neutrophils, monocytes, and lymphocytes in oropharyngeal cancer, Huang et al 5 demonstrate that higher circulating myeloid cells (for example, neutrophils and monocytes) independently predict inferior os and recurrence-free survival after chemoradiotherapy. Preclinical data suggest the presence of an interaction between lymphocytes and myeloid cells in regulating pro-tumour activity compared with antitumour activity in solid tumours, and B and T lymphocytes might play a role in regulating multiple protumour properties of myeloid cells 19,20 .…”

Section: Figure 2 Kaplan-meier Curves For Overall Survival By Neutropmentioning

confidence: 99%

“…Increasing evidence suggests that circulating levels of neutrophils, monocytes, and lymphocytes are associated with variable tumour control and survival in tumour sites, including head-and-neck cancer 5 , ovarian cancer 6 , colorectal cancer 7 , and cervical cancer a . A recent meta-analysis of 13,964 patients participating in twenty-six studies demonstrated that elevated platelet:lymphocyte ratio (plr) is a negative predictor for overall survival (os) with a hazard ratio of 1.60 [95% confidence interval (ci): 1.35 to 1.90; p < 0.01) 8 .…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

et al. 2016

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PurposeIn the present study, we determined the association of pretreatment circulating neutrophils, monocytes, and lymphocytes with clinical outcomes after lung stereotactic body radiotherapy (sbrt).Methods All patients with primary lung cancer and with a complete blood count within 3 months of lung sbrt from 2005 to 2012 were included. Overall survival (os) was calculated using the Kaplan-Meier method. Factors associated with os were investigated using univariable and multivariable Cox proportional hazards regression. Fine-Gray competing risk regression was performed to test the association of the neutrophil:lymphocyte (nlr) and monocyte:lymphocyte (mlr) ratios with two types of failure: disease-related failure and death, and death unrelated to disease. ResultsOf the 299 sbrt patients identified, 122 were eligible for analysis. The median and range of the nlr and mlr were 3.0 (0.3-22.0) and 0.4 (0.1-1.9) respectively. On multivariable analysis, sex (p = 0.02), T stage (p = 0.04), and nlr (p < 0.01) were associated with os. On multivariable analysis, T stage (p < 0.01) and mlr (p < 0.01) were associated with disease-related failure; mlr (p = 0.03), nlr (p < 0.01), and sbrt dose of 48 Gy in 4 fractions (p = 0.03) and 54 Gy or 60 Gy in 3 fractions (p = 0.02) were associated with disease-unrelated death. Median survival was 4.3 years in the nlr≤3 group (95% confidence interval: 3.5 to not reached) and 2.5 years in the nlr>3 group (95% confidence interval: 1.7 to 4.8; p < 0.01). ConclusionsIn lung sbrt patients, nlr and mlr are independently associated with os and disease-unrelated death.If validated, nlr and mlr could help to identify patients who would benefit most from sbrt.

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Section: Figure 2 Kaplan-meier Curves For Overall Survival By Neutropsupporting

confidence: 87%

Section: Patient Selectionmentioning

confidence: 99%

Section: Figure 2 Kaplan-meier Curves For Overall Survival By Neutropmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

et al. 2016

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“…Para este fin, la determinación del número de leucocitos totales y de los diferentes tipos de células blancas es un procedimiento sencillo que permite obtener información útil y que se ha asociado con el pronóstico del cáncer [19][20][21] . Incluso los cocientes neutrófilo/linfocito y plaquetas/ linfocitos se han estudiado como predictores de agresividad, como de mal pronóstico, debido a que los neutrófilos son fuente del factor de crecimiento endotelial, el cual participa en la angiogénesis y aumenta la capacidad de diseminación del tumor.…”

Section: Discussionunclassified

Cáncer del tracto digestivo: asociación entre el estado nutricional y la capacidad funcional

Pérez-Cruz¹,

Camacho-Limas²

2017

GMM

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Association of Posttreatment Lymphopenia and Elevated Neutrophil-to-Lymphocyte Ratio With Poor Clinical Outcomes in Patients With Human Papillomavirus–Negative Oropharyngeal Cancers

Lin

Gang²,

Rao

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Better biomarkers are needed for human papillomavirus (HPV)-negative oropharyngeal cancer (OPC) to identify patients at risk of recurrence. Lymphopenia and an elevated ratio of neutrophils to lymphocytes (NLR) have been associated with poor disease outcomes in a number of solid tumors. OBJECTIVE To test the hypothesis that postradiotherapy lymphopenia and elevated NLR are associated with poor clinical outcomes. DESIGN, SETTING, AND PARTICIPANTS This single-institution retrospective analysis included patients with HPV-negative OPC treated from January 1, 1997, through January 4, 2017. Median follow-up was 37 months (range, 2-197 months). A total of 108 patients with HPV-negative OPC and at least 1 complete blood cell count 2 to 12 months after the start of radiotherapy were included. Data were analyzed from August 26 to September 7, 2017. INTERVENTIONS Surgery followed by radiotherapy vs definitive radiotherapy, with or without chemotherapy. MAIN OUTCOMES AND MEASURES Absolute lymphocyte (ALC) and absolute neutrophil (ANC) counts were tested as variables affecting locoregional control, recurrence-free survival, and overall survival. RESULTS Of a total of 108 patients included in the analysis (87.0% male; mean age, 56 years [range, 35-84 years]), 57 received surgery followed by postoperative radiotherapy and 51 received definitive radiotherapy. During treatment, 67 of 79 patients (84.8%) had grades 3 to 4 lymphopenia and 17 of 79 (21.5%) had grade 4 lymphopenia. The ANC recovered by 6 months after radiotherapy, but ALC remained depressed to 1 year after radiotherapy. Posttreatment lymphopenia and elevated NLR were associated with worse recurrence-free and overall survival. The estimated 3-year LRC in patients with and without grades 3 to 4 lymphopenia at 3 months after radiotherapy start was 73% vs 82% (hazard ratio [HR], 0.58; 95% CI, 0.19-1.8); estimated 3-year recurrence-free survival, 36% vs 63% (HR, 0.45; 95% CI, 0.23-0.87); and estimated 3-year overall survival, 34% vs 64% (HR, 0.45; 95% CI, 0.23-0.88). In multivariable analysis, an association with worse overall survival was found for definitive radiotherapy (HR, 3.3; 95% CI, 1.6-7.1) and grades 3 to 4 lymphopenia (HR, 2.6; 95% CI, 1.3-5.5) at 3 months after radiotherapy. CONCLUSIONS AND RELEVANCE Lymphopenia and NLR as early as 3 months after treatment start may serve as biomarkers of clinical outcomes in patients with HPV-negative OPC. These patients may benefit from adjuvant treatment intensification or closer surveillance.

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Prognostic value of pretreatment circulating neutrophils, monocytes, and lymphocytes in oropharyngeal cancer stratified by human papillomavirus status

Cited by 145 publications

References 46 publications

Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy

Cáncer del tracto digestivo: asociación entre el estado nutricional y la capacidad funcional

Association of Posttreatment Lymphopenia and Elevated Neutrophil-to-Lymphocyte Ratio With Poor Clinical Outcomes in Patients With Human Papillomavirus–Negative Oropharyngeal Cancers

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