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The Pretreatment Neutrophil-to-Lymphocyte Ratio is a Prognostic Determinant of T3–4 Hypopharyngeal Squamous Cell Carcinoma

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

This study aimed to investigate the clinicopathological factors that influence recurrence and survival in patients who undergo operations for T3–4 hypopharyngeal squamous cell carcinomas (SCCs).

Materials and Methods

One hundred and five patients who underwent surgery between 2001 and 2008 for advanced hypopharyngeal SCCs were consecutively enrolled and reviewed.

Results

The pretreatment neutrophil-to-lymphocyte ratio (NLR; median 3.22, range 0.62–46.50) was associated with disease recurrence and patient survival. A difference in the 5-year cumulative disease recurrence rate between patients with high (≥3.22) and low (<3.22) NLRs was significant (60.4 and 36.5%, respectively; p = 0.004). A multivariate analysis confirmed that an NLR ≥3.22 was an independent indicator of a poor prognosis for advanced hypopharyngeal SCC, as per the following parameters: overall survival (hazard ratio [HR] 2.53, 95% confidence interval [CI] 1.48–4.30, p = 0.001), disease-specific survival (HR 2.45, 95% CI 1.38–4.34, p = 0.002), and disease-free survival (HR 2.18, 95% CI 1.24–3.83, p = 0.007). Additional prognostic factors per the survival analyses included lymph node density, surgical margin, lymphovascular invasion, and perineural invasion.

Conclusions

An NLR ≥3.22 is associated with a higher risk of disease recurrence and poor survival in patients with T3–4 hypopharyngeal SCCs. We propose the use of the NLR to broaden the current TNM staging system; the development of a more effective treatment protocol for patients with high NLRs will be essential.

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Acknowledgement

The authors thank American Journal Experts for manuscript editing, and Chien-Hao Chen, PhD, ESTAT Statistical Consulting Co., Ltd, Taipei, Taiwan, for statistical analyses advisement and revision.

Disclosure

The authors declare that they have no competing interest.

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Authors and Affiliations

  1. Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan

    Wu-Chia Lo MD, Chen-Tu Wu MD, Cheng-Ping Wang MD & Yih-Leong Chang MD

  2. Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan

    Wu-Chia Lo MD

  3. Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Chen-Tu Wu MD & Yih-Leong Chang MD

  4. Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

    Cheng-Ping Wang MD, Tsung-Lin Yang MD, PhD, Pei-Jen Lou MD, PhD & Jeng-Yuh Ko MD, PhD

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Correspondence to Yih-Leong Chang MD.

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Lo, WC., Wu, CT., Wang, CP. et al. The Pretreatment Neutrophil-to-Lymphocyte Ratio is a Prognostic Determinant of T3–4 Hypopharyngeal Squamous Cell Carcinoma. Ann Surg Oncol 24, 1980–1988 (2017). https://doi.org/10.1245/s10434-017-5865-8

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  • DOI: https://doi.org/10.1245/s10434-017-5865-8

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