Role of Pretreatment Hemoglobin-to-Platelet Ratio in Predicting Survival Outcome of Locally Advanced Nasopharyngeal Carcinoma Patients

Abstract

Background. The three-year survival rate of locally advanced nasopharyngeal carcinoma (NPC) patients in Indonesia is lower than in other Asian countries. Calculation of hemoglobin-to-platelet ratio (HPR) may become a more practical predictor than the ratios using leukocyte cell components. Yet, no study has been conducted to investigate the potential of HPR in predicting survival outcomes in locally advanced nasopharyngeal cancer patients. Objective. To determine the role of pretreatment hemoglobin-to-platelet ratio in predicting the three-year overall survival (OS) of locally advanced NPC. Method. A retrospective cohort study followed up on 289 locally advanced NPC patients who had undergone therapy at the Dr. Cipto Mangunkusumo National General Hospital between January 2012 and October 2016. HPR cut-off was determined using ROC. Subjects were classified into two groups according to the HPR value. Kaplan-Meier curve was utilized to illustrate patients’ three-year survival, and Cox regression test analyzed confounding variables to yield an adjusted hazard ratio (HR). Results. The optimal cut-off for HPR was 0.362 (AUC 0.6228, 95% CI: 0.56-0.69, sensitivity 61.27%, specificity 60.34%). Of the subjects, 48.44% had HPR ≤ 0.362 , and they had a higher three-year mortality rate than those with HPR > 0.362 (50% vs. 31.54%). In bivariate analysis, HPR ≤ 0.362 and age ≥ 60 significantly showed a worse three-year OS ( p value = 0.003 and 0.075, respectively). In multivariate analysis, we concluded that a pretreatment HPR ≤ 0.362 was an independent negative predictor of three-year OS in locally advanced NPC patients (adjusted HR 1.82; 95% CI: 1.25–2.65). Conclusion. Pretreatment HPR ≤ 0.362 was a negative predictor of three-year OS in locally advanced nasopharyngeal cancer patients.

Potential diagnostic value of the hematological parameters lymphocyte–monocyte ratio and hemoglobin–platelet ratio for detecting colon cancer

“…Our findings are in accordance with those of Mo et al 20 A previous study used HPR to predict overall survival in locally advanced nasopharyngeal cancer, concluding that low HPR was associated with poor 3-year overall survival. 12 Similarly, we found that low pre-operative HPR was linked to worse clinicopathological features, including increased depth of invasion, more lymph node metastasis, more advanced tumor stage, and larger tumor size.…”

“… 8 – 11 Patients with malignant tumors often exhibit anemia, and a reduced hemoglobin–platelet ratio (HPR) is related to poor clinical outcomes in nasopharyngeal carcinoma and renal cell carcinoma. 12 , 13 Carcinoembryonic antigen (CEA) is a member of the immunoglobulin superfamily that acts as an intracellular adhesion molecule. 14 Currently, CEA is the most important common serum biomarker for detecting and monitoring colon cancer but its sensitivity and specificity are insufficient.…”