Neutrophil-to-lymphocyte ratio in head and neck cancer
Introduction The neutrophil‐to‐lymphocyte ratio (NLR) is an index of systemic inflammatory burden in malignancy. An elevated NLR has been associated with poor prognosis in a number of cancer sites. We investigated its role in a cohort of patients with locally advanced head and neck cancer. Methods E...
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| Veröffentlicht in: | Journal of medical imaging and radiation oncology 2015-08, Vol.59 (4), p.514-519 |
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| creator | Haddad, Carol R Guo, Linxin Clarke, Stephen Guminski, Alex Back, Michael Eade, Thomas |
| description | Introduction
The neutrophil‐to‐lymphocyte ratio (NLR) is an index of systemic inflammatory burden in malignancy. An elevated NLR has been associated with poor prognosis in a number of cancer sites. We investigated its role in a cohort of patients with locally advanced head and neck cancer.
Methods
Eligible patients had primary mucosal squamous cell carcinoma treated with chemoradiotherapy and a minimum follow‐up of 12 months (unless deceased). NLR was analysed as |
| doi_str_mv | 10.1111/1754-9485.12305 |
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The neutrophil‐to‐lymphocyte ratio (NLR) is an index of systemic inflammatory burden in malignancy. An elevated NLR has been associated with poor prognosis in a number of cancer sites. We investigated its role in a cohort of patients with locally advanced head and neck cancer.
Methods
Eligible patients had primary mucosal squamous cell carcinoma treated with chemoradiotherapy and a minimum follow‐up of 12 months (unless deceased). NLR was analysed as <5 vs. ≥5 and above and below the median. The primary endpoint was overall survival (OS) and secondary endpoints metastasis free survival and locoregional relapse free survival. Actuarial Kaplan–Meier statistics and log rank test were used. Univariate analysis for age (continuous), Eastern Cooperative Oncology Group performance status (0 vs. 1), gender (male vs. female), smoking (yes vs. no), American Joint Committee on Cancer stage (III vs. IV) and NLR (<5 vs. ≥5 and <3.3 vs. ≥3.3) were performed.
Results
Forty‐six patients were included in this analysis. Median NLR was 3.3 (0.4–22.8). After a median follow‐up of 34 months (13–47 months), the 2‐year estimated OS, metastasis free survival and locoregional relapse free survival for NLR <5 vs. ≥5 were 89% vs. 61% (p = 0.017), 84% vs. 64% (p = 0.083) and 81% vs. 70% (p = 0.17) respectively. On univariate analysis NLR ≥5 (p = 0.025), older age (p = 0.01) and ECOG 1 (p = 0.025) were significant for OS.
Conclusion
In this cohort of locally advanced head and neck cancer patients treated with chemoradiotherapy, pre‐treatment NLR ≥5 was prognostic for mortality. Further studies are required to confirm these results and to assess the interaction with other prognostic factors.</description><identifier>ISSN: 1754-9477</identifier><identifier>EISSN: 1754-9485</identifier><identifier>DOI: 10.1111/1754-9485.12305</identifier><identifier>PMID: 25908427</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Biomarkers - blood ; Carcinoma, Squamous Cell - blood ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Disease-Free Survival ; Female ; Head & neck cancer ; head and neck cancer ; Head and Neck Neoplasms - blood ; Head and Neck Neoplasms - mortality ; Head and Neck Neoplasms - pathology ; Humans ; inflammation ; Leukocyte Count - statistics & numerical data ; Lymphocytes - pathology ; Male ; Medical prognosis ; Metastasis ; Middle Aged ; neutrophil-to-lymphocyte ratio ; Neutrophils - pathology ; New South Wales - epidemiology ; NLR ; Prevalence ; radiotherapy ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Survival Rate</subject><ispartof>Journal of medical imaging and radiation oncology, 2015-08, Vol.59 (4), p.514-519</ispartof><rights>2015 The Royal Australian and New Zealand College of Radiologists</rights><rights>2015 The Royal Australian and New Zealand College of Radiologists.</rights><rights>Copyright © 2015 Royal Australian and New Zealand College of Radiologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5105-d37f2a8fa2ca6e59c0f8f14146729a8f61d2d4f1388bc05061b7e32436e596f43</citedby><cites>FETCH-LOGICAL-c5105-d37f2a8fa2ca6e59c0f8f14146729a8f61d2d4f1388bc05061b7e32436e596f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1754-9485.12305$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1754-9485.12305$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25908427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haddad, Carol R</creatorcontrib><creatorcontrib>Guo, Linxin</creatorcontrib><creatorcontrib>Clarke, Stephen</creatorcontrib><creatorcontrib>Guminski, Alex</creatorcontrib><creatorcontrib>Back, Michael</creatorcontrib><creatorcontrib>Eade, Thomas</creatorcontrib><title>Neutrophil-to-lymphocyte ratio in head and neck cancer</title><title>Journal of medical imaging and radiation oncology</title><addtitle>Journal of Medical Imaging and Radiation Oncology</addtitle><description>Introduction
The neutrophil‐to‐lymphocyte ratio (NLR) is an index of systemic inflammatory burden in malignancy. An elevated NLR has been associated with poor prognosis in a number of cancer sites. We investigated its role in a cohort of patients with locally advanced head and neck cancer.
Methods
Eligible patients had primary mucosal squamous cell carcinoma treated with chemoradiotherapy and a minimum follow‐up of 12 months (unless deceased). NLR was analysed as <5 vs. ≥5 and above and below the median. The primary endpoint was overall survival (OS) and secondary endpoints metastasis free survival and locoregional relapse free survival. Actuarial Kaplan–Meier statistics and log rank test were used. Univariate analysis for age (continuous), Eastern Cooperative Oncology Group performance status (0 vs. 1), gender (male vs. female), smoking (yes vs. no), American Joint Committee on Cancer stage (III vs. IV) and NLR (<5 vs. ≥5 and <3.3 vs. ≥3.3) were performed.
Results
Forty‐six patients were included in this analysis. Median NLR was 3.3 (0.4–22.8). After a median follow‐up of 34 months (13–47 months), the 2‐year estimated OS, metastasis free survival and locoregional relapse free survival for NLR <5 vs. ≥5 were 89% vs. 61% (p = 0.017), 84% vs. 64% (p = 0.083) and 81% vs. 70% (p = 0.17) respectively. On univariate analysis NLR ≥5 (p = 0.025), older age (p = 0.01) and ECOG 1 (p = 0.025) were significant for OS.
Conclusion
In this cohort of locally advanced head and neck cancer patients treated with chemoradiotherapy, pre‐treatment NLR ≥5 was prognostic for mortality. Further studies are required to confirm these results and to assess the interaction with other prognostic factors.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomarkers - blood</subject><subject>Carcinoma, Squamous Cell - blood</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Head & neck cancer</subject><subject>head and neck cancer</subject><subject>Head and Neck Neoplasms - blood</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Humans</subject><subject>inflammation</subject><subject>Leukocyte Count - statistics & numerical data</subject><subject>Lymphocytes - pathology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>neutrophil-to-lymphocyte ratio</subject><subject>Neutrophils - pathology</subject><subject>New South Wales - epidemiology</subject><subject>NLR</subject><subject>Prevalence</subject><subject>radiotherapy</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Survival Rate</subject><issn>1754-9477</issn><issn>1754-9485</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkDtPwzAURi0EglKY2VAkFpa0vn4mI0JQWvUhEK_Nch1HDU2TYieC_ntS-hhY8HKtq_N9ujoIXQDuQPO6IDkLYxbxDhCK-QFq7TeH-7-UJ-jU-w-MBQCLj9EJ4TGOGJEtJMa2rly5nGV5WJVhvlosZ6VZVTZwusrKICuCmdVJoIskKKyZB0YXxrozdJTq3Nvz7Wyjl_u759uHcDjp9W9vhqHhgHmYUJkSHaWaGC0sjw1OoxQYMCFJ3OwFJCRhKdAomhrMm_um0lLC6BoWKaNtdL3pXbrys7a-UovMG5vnurBl7RVIjAELyWiDXv1BP8raFc11CkQcgxSS44bqbijjSu-dTdXSZQvtVgqwWitVa2lqLVD9Km0Sl9veerqwyZ7fOWwAuQG-styu_utTg1H_abKrDjfJzFf2e5_Ubq6EpJKrt3FPjQbvGB5fB4rQHzfvjVU</recordid><startdate>201508</startdate><enddate>201508</enddate><creator>Haddad, Carol R</creator><creator>Guo, Linxin</creator><creator>Clarke, Stephen</creator><creator>Guminski, Alex</creator><creator>Back, Michael</creator><creator>Eade, Thomas</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201508</creationdate><title>Neutrophil-to-lymphocyte ratio in head and neck cancer</title><author>Haddad, Carol R ; Guo, Linxin ; Clarke, Stephen ; Guminski, Alex ; Back, Michael ; Eade, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5105-d37f2a8fa2ca6e59c0f8f14146729a8f61d2d4f1388bc05061b7e32436e596f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomarkers - blood</topic><topic>Carcinoma, Squamous Cell - blood</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Head & neck cancer</topic><topic>head and neck cancer</topic><topic>Head and Neck Neoplasms - blood</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Humans</topic><topic>inflammation</topic><topic>Leukocyte Count - statistics & numerical data</topic><topic>Lymphocytes - pathology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>neutrophil-to-lymphocyte ratio</topic><topic>Neutrophils - pathology</topic><topic>New South Wales - epidemiology</topic><topic>NLR</topic><topic>Prevalence</topic><topic>radiotherapy</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haddad, Carol R</creatorcontrib><creatorcontrib>Guo, Linxin</creatorcontrib><creatorcontrib>Clarke, Stephen</creatorcontrib><creatorcontrib>Guminski, Alex</creatorcontrib><creatorcontrib>Back, Michael</creatorcontrib><creatorcontrib>Eade, Thomas</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of medical imaging and radiation oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haddad, Carol R</au><au>Guo, Linxin</au><au>Clarke, Stephen</au><au>Guminski, Alex</au><au>Back, Michael</au><au>Eade, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil-to-lymphocyte ratio in head and neck cancer</atitle><jtitle>Journal of medical imaging and radiation oncology</jtitle><addtitle>Journal of Medical Imaging and Radiation Oncology</addtitle><date>2015-08</date><risdate>2015</risdate><volume>59</volume><issue>4</issue><spage>514</spage><epage>519</epage><pages>514-519</pages><issn>1754-9477</issn><eissn>1754-9485</eissn><abstract>Introduction
The neutrophil‐to‐lymphocyte ratio (NLR) is an index of systemic inflammatory burden in malignancy. An elevated NLR has been associated with poor prognosis in a number of cancer sites. We investigated its role in a cohort of patients with locally advanced head and neck cancer.
Methods
Eligible patients had primary mucosal squamous cell carcinoma treated with chemoradiotherapy and a minimum follow‐up of 12 months (unless deceased). NLR was analysed as <5 vs. ≥5 and above and below the median. The primary endpoint was overall survival (OS) and secondary endpoints metastasis free survival and locoregional relapse free survival. Actuarial Kaplan–Meier statistics and log rank test were used. Univariate analysis for age (continuous), Eastern Cooperative Oncology Group performance status (0 vs. 1), gender (male vs. female), smoking (yes vs. no), American Joint Committee on Cancer stage (III vs. IV) and NLR (<5 vs. ≥5 and <3.3 vs. ≥3.3) were performed.
Results
Forty‐six patients were included in this analysis. Median NLR was 3.3 (0.4–22.8). After a median follow‐up of 34 months (13–47 months), the 2‐year estimated OS, metastasis free survival and locoregional relapse free survival for NLR <5 vs. ≥5 were 89% vs. 61% (p = 0.017), 84% vs. 64% (p = 0.083) and 81% vs. 70% (p = 0.17) respectively. On univariate analysis NLR ≥5 (p = 0.025), older age (p = 0.01) and ECOG 1 (p = 0.025) were significant for OS.
Conclusion
In this cohort of locally advanced head and neck cancer patients treated with chemoradiotherapy, pre‐treatment NLR ≥5 was prognostic for mortality. Further studies are required to confirm these results and to assess the interaction with other prognostic factors.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>25908427</pmid><doi>10.1111/1754-9485.12305</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Biomarkers - blood Carcinoma, Squamous Cell - blood Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Disease-Free Survival Female Head & neck cancer head and neck cancer Head and Neck Neoplasms - blood Head and Neck Neoplasms - mortality Head and Neck Neoplasms - pathology Humans inflammation Leukocyte Count - statistics & numerical data Lymphocytes - pathology Male Medical prognosis Metastasis Middle Aged neutrophil-to-lymphocyte ratio Neutrophils - pathology New South Wales - epidemiology NLR Prevalence radiotherapy Reproducibility of Results Risk Factors Sensitivity and Specificity Survival Rate |
| title | Neutrophil-to-lymphocyte ratio in head and neck cancer |
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