Fibrinogen and Neutrophil-to-lymphocyte Ratio Predicts Survival in Patients with Advanced Hypopharyngeal Squamous Cell Carcinoma

Anticancer Res. 2018 Sep;38(9):5321-5330. doi: 10.21873/anticanres.12859.

Abstract

Background/aim: The purpose of this study is to investigate the prognostic significance of the pretreatment F-NLR score, which is based on fibrinogen (F) and neutrophil-to-lymphocyte ratio (NLR) in patients with advanced hypopharyngeal carcinoma (HPC).

Materials and methods: A total of 111 advanced HPC patients treated with radiotherapy, chemoradiotherapy, or bioradiotherapy were classified into three groups: F-NLR score of 2 (fibrinogen ≥341 mg/dl and NLR≥3.59), score of 1 (fibrinogen ≥341 mg/dl or NLR≥3.59), and score of 0 (fibrinogen <341 mg/dl and NLR<3.59).

Results: F-NLR score of 2 was an independent prognostic factor for overall (OS) and progression-free survival (PFS) in patients with advanced HPC in the multivariate analysis. Both OS and PFS were significantly lower in patients with an F-NLR score of 2 than in those with an F-NLR score of 0.

Conclusion: F-NLR score was useful to stratify patients to extract poor prognostic characteristics in patients with advanced HPC.

Keywords: F-NLR score; Pretreatment biomarker; hypopharyngeal squamous cell carcinoma; neutrophil-to-lymphocyte ratio; radiotherapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Biomarkers, Tumor / blood
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Decision Support Techniques*
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Fibrinogen / analysis*
  • Head and Neck Neoplasms / blood*
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy
  • Humans
  • Hypopharyngeal Neoplasms / blood*
  • Hypopharyngeal Neoplasms / mortality
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / therapy
  • Kaplan-Meier Estimate
  • Lymphocyte Count
  • Lymphocytes*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • ROC Curve
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Squamous Cell Carcinoma of Head and Neck
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Fibrinogen