Survival impact of pre-treatment neutrophils on oropharyngeal and laryngeal cancer patients undergoing definitive radiotherapy

J Transl Med. 2017 Aug 2;15(1):168. doi: 10.1186/s12967-017-1268-7.

Abstract

Background: Squamous cell carcinoma of the head and neck (HNSCC) represents an array of disease processes with a generally unfavorable prognosis. Inflammation plays an important role in tumor development and response to therapy. We performed a retrospective analysis of HNSCC patients to explore the relationship of the lymphocyte and neutrophil counts, the neutrophil-to-lymphocyte ratio (NLR) overall survival (OS), cancer-specific survival (CSS), local control (LC) and distant control (DC).

Materials/methods: All patients received definitive treatment for cancers of the oropharynx or larynx between 2006-2015. Neutrophil and lymphocyte counts were collected pre-, during-, and post-treatment. The correlations of patient, tumor, and biological factors to OS, CSS, LC and DC were assessed.

Results: 196 patients met our inclusion criteria; 171 patients were Stage III or IV. Median follow-up was 2.7 years. A higher neutrophil count at all treatment time points was predictive of poor OS with the pre-treatment neutrophil count and overall neutrophil nadir additionally predictive of DC. Higher pre-treatment and overall NLR correlated to worse OS and DC, respectively.

Conclusion: A higher pre-treatment neutrophil count correlates to poor OS, CSS and DC. Lymphocyte counts were not found to impact survival or tumor control. Higher pre-treatment NLR is prognostic of poor OS.

Keywords: Chemoradiation; Larynx; Neutrophil; Oropharynx; SCC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / blood
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / radiotherapy*
  • Lymphocyte Count
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils / pathology*
  • Oropharyngeal Neoplasms / blood
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / radiotherapy*
  • Prognosis
  • Survival Analysis