Different inflammatory blood markers correlate with specific outcomes in incident HPV-negative head and neck squamous cell carcinoma: a retrospective cohort study
Paolo Boscolo-Rizzo,
Andrea D’Alessandro,
Jerry Polesel,
Daniele Borsetto,
Margherita Tofanelli,
Alberto Deganello,
Michele Tomasoni,
Piero Nicolai,
Paolo Bossi,
Giacomo Spinato,
Anna Menegaldo,
Andrea Ciorba,
Stefano Pelucchi,
Chiara Bianchini,
Diego Cazzador,
Giulia Ramaciotti,
Valentina Lupato,
Vittorio Giacomarra,
Gabriele Molteni,
Daniele Marchioni,
Cristoforo Fabbris,
Antonio Occhini,
Giulia Bertino,
Jonathan Fussey,
Giancarlo Tirelli
Affiliations
Paolo Boscolo-Rizzo
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste
Andrea D’Alessandro
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste
Jerry Polesel
Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS
Daniele Borsetto
Department of ENT, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust
Margherita Tofanelli
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste
Alberto Deganello
Department of Otolaryngology, Head and Neck Surgery, University of Brescia
Michele Tomasoni
Department of Otolaryngology, Head and Neck Surgery, University of Brescia
Piero Nicolai
Department of Otolaryngology, Head and Neck Surgery, University of Brescia
Paolo Bossi
Department of Medical Oncology, University of Brescia
Giacomo Spinato
Unit of Otolaryngology
Anna Menegaldo
Unit of Otolaryngology
Andrea Ciorba
ENT Department, University Hospital of Ferrara
Stefano Pelucchi
ENT Department, University Hospital of Ferrara
Chiara Bianchini
ENT Department, University Hospital of Ferrara
Diego Cazzador
Department of Neurosciences, Section of Otolaryngology, University of Padova
Giulia Ramaciotti
Department of Neurosciences, Section of Otolaryngology, University of Padova
Valentina Lupato
Unit of Otolaryngology, Azienda Ospedaliera “S. Maria Degli Angeli”
Vittorio Giacomarra
Unit of Otolaryngology, Azienda Ospedaliera “S. Maria Degli Angeli”
Gabriele Molteni
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Otolaryngology, University of Verona
Daniele Marchioni
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Otolaryngology, University of Verona
Cristoforo Fabbris
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Otolaryngology, University of Verona
Antonio Occhini
Department of Otolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation
Giulia Bertino
Department of Otolaryngology, University of Pavia, IRCCS Policlinico San Matteo Foundation
Jonathan Fussey
Department of ENT/Head and Neck Surgery, Elizabeth University Hospital Birmingham
Giancarlo Tirelli
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste
Abstract Background Inflammatory blood markers have been associated with oncological outcomes in several cancers, but evidence for head and neck squamous cell carcinoma (HNSCC) is scanty. Therefore, this study aims at investigating the association between five different inflammatory blood markers and several oncological outcomes. Methods This multi-centre retrospective analysis included 925 consecutive patients with primary HPV-negative HNSCC (median age: 68 years) diagnosed between April 2004 and June 2018, whose pre-treatment blood parameters were available. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), systemic inflammatory marker (SIM), and systemic immune-inflammation index (SII) were calculated; their associations with local, regional, and distant failure, disease-free survival (DFS), and overall survival (OS) was calculated. Results The median follow-up was 53 months. All five indexes were significantly associated with OS; the highest accuracy in predicting patients’ survival was found for SIM (10-year OS = 53.2% for SIM < 1.40 and 40.9% for SIM ≥ 2.46; c-index = 0.569) and LMR (10-year OS = 60.4% for LMR ≥ 3.76 and 40.5% for LMR < 2.92; c-index = 0.568). While LMR showed the strongest association with local failure (HR = 2.16; 95% CI:1.22–3.84), PLR showed the strongest association with regional (HR = 1.98; 95% CI:1.24–3.15) and distant failure (HR = 1.67; 95% CI:1.08–2.58). Conclusion Different inflammatory blood markers may be useful to identify patients at risk of local, regional, or distant recurrences who may benefit from treatment intensification or intensive surveillance programs.
