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Prognostic impact of pretherapeutic laboratory values in head and neck cancer patients

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Abstract

Purpose

The high comorbidity in patients with head and neck cancer (HNC) is mainly caused by the high incidence of tobacco and alcohol abuse and has direct impact on overall survival. We investigated whether HNC and its comorbidity also influence routine laboratory values and whether these values have influence on overall survival.

Methods

A retrospective cohort of 261 patients with primary squamous cell carcinoma of the oral cavity, pharynx, or larynx diagnosed between 2001 and 2006 with a complete set of pretherapeutic laboratory values was identified. The influence of standard oncological parameters, comorbidity, and each laboratory value on overall survival (OS) was investigated in univariate and multivariate analyses.

Results

Two-thirds of patients were active smokers and about one half reported high alcohol consumption. 40 % of patients had severe comorbidity according to Charlson comorbidity index. The most frequent laboratory pathologies were elevated C-reactive protein (CRP) values (66 %), impaired liver enzymes (30–50 %), decreased urea levels (33 %), leukocytosis (20 %), and anemia (10 %). In multivariate analysis for OS, a comorbidity index ≥5 (Hazard ratio [HR], 2.008; 95 % confidence interval [CI], 1.117–3.610; p = 0.020), high CRP level (HR, 2.469; CI, 1.414–4.310; p = 0.001), and abnormal low red-cell count (HR, 2.525; CI, 1.250–5.102; p = 0.010) were independent prognostic variables.

Conclusions

Comorbidity reflected by pathologic laboratory values is a major issue in HNC patients. Several pretherapeutic laboratory values have prognostic relevance for overall survival in HNC patients.

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References

  • Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefebvre JL, Greiner RH, Giralt J, Maingon P, Rolland F, Bolla M, Cognetti F, Bourhis J, Kirkpatrick A, van Glabbeke M (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350(19):1945–1952

    Article  PubMed  CAS  Google Scholar 

  • Bleeker JS, Hogan WJ (2011) Thrombocytosis: diagnostic evaluation, thrombotic risk stratification, and risk-based management strategies. Thrombosis 2011:536062. doi:10.1155/2011/536062

    Article  PubMed  Google Scholar 

  • Chapireau D, Adlam D, Cameron M, Thompson M (2010) Paraneoplastic syndromes in patients with primary oral cancers: a systematic review. Br J Oral Maxillofacial Surg 48(5):338–344

    Article  Google Scholar 

  • Chen HH, Chen IH, Liao CT, Wei FC, Lee LY, Huang SF (2011) Preoperative circulating C-reactive protein levels predict pathological aggressiveness in oral squamous cell carcinoma: a retrospective clinical study. Clin Otolaryngol 36(2):147–153

    Article  PubMed  Google Scholar 

  • Datema FR, Ferrier MB, van der Schroeff MP, Baatenburg de Jong RJ (2010) Impact of comorbidity on short-term mortality and overall survival of head and neck cancer patients. Head Neck 32(6):728–736

    PubMed  Google Scholar 

  • D’Hoore W, Sicotte C, Tilquin C (1993) Risk adjustment in outcome assessment: the Charlson comorbidity index. Meth Inform Med 32(5):382–387

    PubMed  Google Scholar 

  • Gaudet MM, Olshan AF, Chuang SC, Berthiller J, Zhang ZF, Lissowska J, Zaridze D, Winn DM, Wei Q, Talamini R, Szeszenia-Dabrowska N, Sturgis EM, Schwartz SM, Rudnai P, Eluf-Neto J, Muscat J, Morgenstern H, Menezes A, Matos E, Bucur A, Levi F, Lazarus P, La Vecchia C, Koifman S, Kelsey K, Herrero R, Hayes RB, Franceschi S, Wunsch-Filho V, Fernandez L, Fabianova E, Daudt AW, Dal Maso L, Curado MP, Chen C, Castellsague X, Benhamou S, Boffetta P, Brennan P, Hashibe M (2010) Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. Int J Epidemiol 39(4):1091–1102

    Article  PubMed  Google Scholar 

  • Gimeno-Hernandez J, Iglesias-Moreno MC, Gomez-Serrano M, Carricondo F, Gil-Loyzaga P, Poch-Broto J (2011) The impact of comorbidity on the survival of patients with laryngeal squamous cell carcinoma. Acta Otolaryngol 131(8):840–846

    Article  PubMed  Google Scholar 

  • Greve J, Schuler PJ, Bas M, Adamzik M, Brandau S, Arweiler-Harbeck D, Lang S, Hoffmann TK (2010) Coagulation factors as potential tumour markers in patients with head and neck carcinomas? Laryngorhinootol 89(10):612–615

    Article  CAS  Google Scholar 

  • Guntinas-Lichius O, Wendt T, Buentzel J, Esser D, Lochner P, Mueller A, Schultze-Mosgau S, Altendorf-Hofmann A (2010) Head and neck cancer in Germany: a site-specific analysis of survival of the Thuringian cancer registration database. J Cancer Res Clin Oncol 136(1):55–63

    Article  PubMed  Google Scholar 

  • Khandavilli SD, Ceallaigh PO, Lloyd CJ, Whitaker R (2009) Serum C-reactive protein as a prognostic indicator in patients with oral squamous cell carcinoma. Oral Oncol 45(10):912–914

    Article  PubMed  CAS  Google Scholar 

  • Kruse AL, Luebbers HT, Gratz KW (2010) C-reactive protein levels: a prognostic marker for patients with head and neck cancer? Head Neck Oncol 2:21

    Article  PubMed  Google Scholar 

  • Kruse AL, Luebbers HT, Gratz KW (2011) Evaluation of white blood cell count as a possible prognostic marker for oral cancer. Head Neck Oncol 3:13

    Article  PubMed  Google Scholar 

  • Lee L, Cheung WY, Atkinson E, Krzyzanowska MK (2011) Impact of comorbidity on chemotherapy use and outcomes in solid tumors: a systematic review. J Clin Oncol 29(1):106–117

    Article  PubMed  Google Scholar 

  • Lu CC, Chang KW, Chou FC, Cheng CY, Liu CJ (2007) Association of pretreatment thrombocytosis with disease progression and survival in oral squamous cell carcinoma. Oral Oncol 43(3):283–288

    Article  PubMed  CAS  Google Scholar 

  • Mell LK, Dignam JJ, Salama JK, Cohen EE, Polite BN, Dandekar V, Bhate AD, Witt ME, Haraf DJ, Mittal BB, Vokes EE, Weichselbaum RR (2010) Predictors of competing mortality in advanced head and neck cancer. J Clin Oncol 28(1):15–20

    Article  PubMed  Google Scholar 

  • Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C (2008) Alcohol and tobacco use, and cancer risk for upper aerodigestive tract and liver. Eur J Cancer Prev 17(4):340–344

    Article  PubMed  Google Scholar 

  • Posner MR, Hershock DM, Blajman CR, Mickiewicz E, Winquist E, Gorbounova V, Tjulandin S, Shin DM, Cullen K, Ervin TJ, Murphy BA, Raez LE, Cohen RB, Spaulding M, Tishler RB, Roth B, Viroglio Rdel C, Venkatesan V, Romanov I, Agarwala S, Harter KW, Dugan M, Cmelak A, Markoe AM, Read PW, Steinbrenner L, Colevas AD, Norris CM Jr, Haddad RI (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. New Engl J Med 357(17):1705–1715

    Article  PubMed  CAS  Google Scholar 

  • Rose BS, Jeong JH, Nath SK, Lu SM, Mell LK (2011) Population-based study of competing mortality in head and neck cancer. J Clin Oncol 29(26):3503–3509

    Article  PubMed  Google Scholar 

  • Sanabria A, Carvalho AL, Vartanian JG, Magrin J, Ikeda MK, Kowalski LP (2007) Comorbidity is a prognostic factor in elderly patients with head and neck cancer. Ann Surg Oncol 14(4):1449–1457

    Article  PubMed  Google Scholar 

  • Toro C, Rinaldo A, Silver CE, Politi M, Ferlito A (2010) Paraneoplastic syndromes in patients with oral cancer. Oral Oncol 46(1):14–18

    Article  PubMed  CAS  Google Scholar 

  • van de Pol SM, Doornaert PA, de Bree R, Leemans CR, Slotman BJ, Langendijk JA (2006) The significance of anemia in squamous cell head and neck cancer treated with surgery and postoperative radiotherapy. Oral Oncol 42(2):131–138

    Article  PubMed  Google Scholar 

  • Yung KC, Piccirillo JF (2008) The incidence and impact of comorbidity diagnosed after the onset of head and neck cancer. Arch Otolaryngol Head Neck Surg 134(10):1045–1049

    Article  PubMed  Google Scholar 

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Correspondence to Orlando Guntinas-Lichius.

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Peter, F., Wittekindt, C., Finkensieper, M. et al. Prognostic impact of pretherapeutic laboratory values in head and neck cancer patients. J Cancer Res Clin Oncol 139, 171–178 (2013). https://doi.org/10.1007/s00432-012-1320-1

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  • DOI: https://doi.org/10.1007/s00432-012-1320-1

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