Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma : A Systematic Review and Meta-Analysis
Rodrigo, Juan Pablo (Centro de Investigación Biomédica en Red de Cáncer)
Sánchez-Canteli, Mario (Universidad de Oviedo)
Triantafyllou, Asterios (University of Liverpool)
de Bree, Remco (University Medical Center Utrecht)
Mäkitie, Antti A. (Helsinki University Hospital)
Franchi, Alessandro (University of Pisa)
Hellquist, Henrik (University of Algarve)
Saba, Nabil F. (Emory University School of Medicine)
Stenman, Göran (University of Gothenburg)
Takes, Robert P. (Radboud University Medical Center)
Valero Mayor, Cristina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Zidar, Nina (Univerza V Ljubljani)
Ferlito, Alfio (International Head and Neck Scientific Group (Itàlia))
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Neutrophil-to-lymphocyte ratio (NLR) in peripheral blood samples has been associated with prognosis in several cancers, including head and neck cancer, but in oropharyngeal carcinomas its prognostic value, especially in relation to human papillomavirus (HPV) infection, has been little studied. This meta-analysis, including studies on the prognostic value of NLR in oropharyngeal carcinoma, shows that an elevated pretreatment NLR is associated with a worse prognosis in oropharyngeal cancer, regardless of the type of treatment performed, but this prognostic value appears to be specific to HPV-positive oropharyngeal carcinomas. NLR could be used as an affordable prognostic marker in this type of cancer. Neutrophil-to-lymphocyte ratio (NLR) has been associated with survival in various cancers, including head and neck cancer. However, there is limited information on its role in oropharyngeal squamous cell carcinomas (OPSCC) according to HPV status. This prompted the present meta-analysis. Studies were selected when the prognostic value of NLR prior to treatment was evaluated in OPSCC patients, the cutoff value of NLR was available, and the prognostic value of NLR was evaluated by time-to-event survival analysis. A total of 14 out of 492 articles, including 7647 patients, were analyzed. The results showed a worse prognosis for the patients with a high NLR: The combined hazard ratios (HR) for overall survival (OS) in patients with an elevated NLR was 1. 56 (95% confidence interval (CI) 1. 21-2. 02; p = 0. 0006), for disease-free survival was 1. 52 (95% CI 1. 34-1. 73; p < 0. 00001), and for recurrence-free survival was 1. 86 (95% CI 1. 50-2. 30; p < 0. 00001). This worse prognosis of high NLR was exclusive of HPV-positive patients: HR for OS in the HPV-positive subgroup was 4. 05 (95% CI 1. 90-8. 62 (p = 0. 0003), and in the HPV-negative subgroup 0. 92 (95% CI 0. 47-1. 80; p = 0. 82). The prognosis of NLR was not influenced by treatment: The HR for OS for patients treated with radiotherapy/chemoradiotherapy (RT/CRT) was 1. 48 (95% CI 1. 09-2. 01; p = 0. 01), and for patients treated with surgery (±RT/CRT) was 1. 72 (95% CI 1. 08-2. 72; p = 0. 02). In conclusion, an elevated NLR relates to worse outcomes in patients with HPV-positive OPSCC.
Ajuts:	Instituto de Salud Carlos III PI19/00560 Ministerio de Economía y Competitividad CB16/12/00390
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Meta-analysis ; Neutrophil-to-lymphocyte ratio ; Oropharyngeal squamous cell carcinoma ; Prognosis
Publicat a:	Cancers, Vol. 15 (january 2023) , ISSN 2072-6694

DOI: 10.3390/cancers15030802
PMID: 36765760

13 p, 2.3 MB

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