The prognostic value of systemic and local inflammation in patients with laryngeal squamous cell carcinoma

Abstract

BackgroundCancer-related systemic inflammation has been demonstrated to be associated with poor outcome in multiple types of cancers. Meanwhile, the local inflammation, which is characterized by dense intratumoral immune infiltrate, is a favorable predictor of survival outcome.PurposeTo evaluate the role of systemic and local inflammation in predicting outcome in patients with laryngeal squamous cell carcinoma.Patients and methodsIn this retrospective study, 120 patients who had undergone postoperative radiotherapy were enrolled. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as calculated from pretreatment whole blood counts, were used to indicate systemic inflammation. The optimal cutoff values of NLR and PLR were determined using receiver operating characteristic curve analysis. Tumor infiltrating lymphocytes (TILs) density, as assessed by pathologist review of hematoxylin and eosin-stained slides, was used to represent local inflammation. Overall survival (OS) and recurrence-free survival (RFS) were assessed using the Kaplan–Meier method and multivariate Cox regression analysis.ResultsThe best cutoff was 2.79 for NLR and 112 for PLR. Kaplan–Meier analysis revealed that high NLR, high PLR, and low TILs density were significantly correlated with inferior OS and RFS, respectively (all P<0.05). The Cox proportional multivariate hazard model showed that a high pretreatment PLR and a low TILs density were both independently correlated with poor OS and RFS, respectively (all P<0.05).ConclusionMarkers of systemic and local inflammation, especially PLR and TILs density, are reliable prognostic factors in patients with laryngeal squamous cell carcinoma.

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

“…Therefore, meta-analyses were conducted with a random effect model, using Comprehensive Meta-Analysis version 2 (Biostat, Englewood, NJ). However, only 4 studies 38,42,44,46 were subjected to subgroup analyses for disease sites because the other studies reported the HRs of patients with different affected sites together. Most of the included studies dichotomized patients into 2 groups according to the platelet count or PLR.…”

“…The HRs for DSS were reported in 3 studies and ranged from 0.95 to 1.62; none were statistically significant 37,39,51 ( Figure 2B). Table 2 37,38,[41][42][43][44][45][46]51 shows the characteristics of the included studies for PLR analysis. The pooled HR for DSS was 1.13 (95% CI 0.90-1.43), and the result was not statistically significant.…”

“…The pooled analysis for the 3 studies involved 1956 patients and is shown in Figure 2B. 38,[41][42][43][44][45][46]51 The outcomes analyzed in these studies were OS in 7 studies 37,38,[41][42][43][44]46 and DSS in 3 studies. The result was similar when any individual study was removed from the analysis (Supporting Information Figure S1B).…”

“…On the other hand, the information from blood samples demonstrates only the indirect consequences of cancer progression. [34][35][36][37][38][39][40][41][42][43][44][45][46] Among these studies, only 1 study was prospective. Moreover, blood markers are not affected by any heterogeneity within the tumor.…”

Assessing Tumor-Infiltrating Lymphocytes in Solid Tumors: A Practical Review for Pathologists and Proposal for a Standardized Method from the International Immuno-Oncology Biomarkers Working Group: Part 2: TILs in Melanoma, Gastrointestinal Tract Carcinomas, Non–Small Cell Lung Carcinoma and Mesothelioma, Endometrial and Ovarian Carcinomas, Squamous Cell Carcinoma of the Head and Neck, Genitourinary Carcinomas, and Primary Brain Tumors

“…Similar favorable findings were seen with increased intra-tumoral or stromal CD8 + cells [240], while increased numbers of FOXP3 + T regs may have detrimental effects oral cavity squamous cell carcinoma outcome [241]. Vassilakopoulou et al and Wang et al applied the consensus TILs scoring guidelines from the International Immuno-Oncology Biomarkers Working Group [1] to laryngeal squamous cell carcinoma, and both studies found that the sTILs score was an independent prognostic factor for disease free and overall survival [242,243]. …”