Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma

Lorenzo Fernandes Moça Trevisani; Isabelle Fernandes Kulcsar; Marco Aurélio Vamondes Kulcsar; Rogerio Aparecido Dedivitis; Luiz Paulo Kowalski; Leandro Luongo Matos

doi:10.3390/cancers15215245

Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma

Cancers (Basel). 2023 Oct 31;15(21):5245. doi: 10.3390/cancers15215245.

Authors

Lorenzo Fernandes Moça Trevisani¹, Isabelle Fernandes Kulcsar², Marco Aurélio Vamondes Kulcsar³, Rogerio Aparecido Dedivitis⁴, Luiz Paulo Kowalski⁵, Leandro Luongo Matos^{3

6}

Affiliations

¹ Programa de Pós-Graduação em Anestesiologia, Ciências Cirúrgicas e Medicina Perioperatória, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, Brazil.
² Instituto do Câncer do Estado de São Paulo (Icesp), Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil.
³ Head and Neck Surgery Department, Instituto do Câncer do Estado de São Paulo (Icesp), Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil.
⁴ Head and Neck Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil.
⁵ Head and Neck Surgery Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil.
⁶ Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo 05652-000, Brazil.

Abstract

Introduction: Oral squamous cell carcinoma (OSCC) remains a significant public health concern. The variables utilized to determine appropriate treatment for this disease also represent its most unfavorable prognostic factors, with these parameters solely determined by the neoplasm and its behavior. However, a lack of well-established indices is evident in the literature that specifically relate to the patient and indicate a worse prognosis.

Objective: To assess the prognostic impact of hematological indices in patients with OSCC.

Methods: This retrospective cohort study included patients with oral squamous cell carcinoma (OSCC) who underwent curative-intent treatment. Treatment encompassed surgery, followed by adjuvant therapy, as necessary. Laboratory tests were conducted immediately prior to surgery, and demographic information was obtained from medical records.

Results: The cohort comprised 600 patients, with 73.5% being male subjects. Adjuvant treatment was recommended for 60.3% of patients. Throughout the follow-up period, 48.8% of participants died. Univariate analysis indicated that perineural invasion, angiolymphatic invasion, pT4 tumors, lymph node metastases, extranodal extravasation, RDW > 14.3%, NLR (neutrophil-lymphocyte ratio) > 3.38, PLR (platelet-lymphocyte ratio) > 167.3, and SII (systemic inflammatory/immune response index) > 416.1 were factors associated with increased mortality. These threshold values were established through ROC curve analysis. In the multivariate analysis, angiolymphatic invasion (HR = 1.43; 95% CI: 1.076-1.925; p = 0.014), pT4a/b tumors (HR = 1.761; 95% CI: 1.327-2.337; p < 0.001), extranodal extravasation (HR = 1.420; 95% CI: 1.047-1.926; p = 0.024), and RDW (HR = 1.541; 95% CI: 1.153-2.056; p = 0.003) were identified as independent risk factors for decreased overall survival.

Conclusions: RDW > 14.3% was proven to be a reliable parameter for assessing overall survival in patients with OSCC. Further studies are required to evaluate the clinical applicability of other hematological indices.

Keywords: RDW; oral squamous cell carcinoma; prognosis.

Abstract

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