Prognostic significance of platelet‑to‑albumin ratio in patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy: a retrospective study of 858 cases
Xin Hua,
Fei Xu,
Wei Shi,
Zhi-Qing Long,
Xin Huang,
Fang-Fang Duan,
Si-Fen Wang,
Chao Zhang,
Meng-Di Wang,
Wei-Qiong Ni,
Wen Xia,
Jia-Yi Chen,
Yun-Sheng Gao
Affiliations
Xin Hua
Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Fei Xu
Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Wei Shi
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University
Zhi-Qing Long
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, SunYat-sen University Cancer Center
Xin Huang
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, SunYat-sen University Cancer Center
Fang-Fang Duan
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, SunYat-sen University Cancer Center
Si-Fen Wang
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, SunYat-sen University Cancer Center
Chao Zhang
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, SunYat-sen University Cancer Center
Meng-Di Wang
Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Wei-Qiong Ni
Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Wen Xia
State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, SunYat-sen University Cancer Center
Jia-Yi Chen
Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Yun-Sheng Gao
Department of Radiation Oncology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital
Abstract Background Despite evidence supporting the high correlation of the novel platelet-to-albumin ratio (PAR) with survival in diverse malignancies, its prognostic relevance in nasopharyngeal carcinoma (NPC) remains underexplored. This study aimed to examine the link between PAR and overall survival (OS) in NPC and to establish a predictive model based on this biomarker. Methods We retrospectively assembled a cohort consisting of 858 NPC patients who underwent concurrent chemoradiotherapy (CCRT). Utilizing the maximally selected log-rank method, we ascertained the optimal cut-off point for the PAR. Subsequently, univariate and multivariate Cox proportional hazards models were employed to discern factors significantly associated with OS and to construct a predictive nomogram. Further, we subjected the nomogram’s predictive accuracy to rigorous independent validation. Results The discriminative optimal PAR threshold was determined to be 4.47, effectively stratifying NPC patients into two prognostically distinct subgroups (hazard ratio [HR] = 0.53; 95% confidence interval [CI]: 0.28–0.98, P = 0.042). A predictive nomogram was formulated using the results from multivariate analysis, which revealed age greater than 45 years, T stage, N stage, and PAR score as independent predictors of OS. The nomogram demonstrated a commendable predictive capability for OS, with a C-index of 0.69 (95% CI: 0.64–0.75), surpassing the performance of the conventional staging system, which had a C-index of 0.56 (95% CI: 0.65–0.74). Conclusions In the context of NPC patients undergoing CCRT, the novel nutritional-inflammatory biomarker PAR emerges as a promising, cost-efficient, easily accessible, non-invasive, and potentially valuable predictor of prognosis. The predictive efficacy of the nomogram incorporating the PAR score exceeded that of the conventional staging approach, thereby indicating its potential as an enhanced prognostic tool in this clinical setting.
