Low pre-treatment Lymphocyte Monocyte Ratio (LMR) and high Platelet Lymphocyte Ratio (PLR) indicates poor cancer outcome in early tongue cancer

Publication date: Available online 26 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Hui Shan Ong, Sandhya Gokavarapu, LI Zhen Wang, Zhen Tian, Chen Ping Zhang
BackgroundThe WBC indices are reported to have a prognostic impact in cancer of multiple organs including head and neck cancer; however; site and stage stratification was not attempted and compelling evidence shows that the early cancers have different distribution and prognostication to late stages. We studied the prognostic importance of WBC indices in early oral tongue cancers.Patients and methodsA retrospective data of primary pT1-T2N0 oral tongue cancers treated between 2009 to 2013 were charted, the WBC indices such as neutrophil count(NC), lymphocyte count(LC), platelet count(PC) and monocyte count(MC) along with derived indices such as neutrophil lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR) and lymphocyte monocyte ratio(LMR) were analyzed in multivariate analysis with other clinicopathological prognostic factors.ResultsA total of 133 patients fulfilled the inclusion criteria, minimum follow up for alive patients was 36 months. A total of 22 patients reported disease relapse and 11 patients died of disease. Multivariate analysis showed LC (HR=0.206; 95% CI:0.092-0.46, p<0.001), PC (HR=1.011; 95% CI:1.001-1.021, p=0.026), PLR (HR=1.012; 95% CI:1.008-1.016, p<0.001) and LMR (HR=0.721; 95% CI:0596-0.872, p=0.001) are significant independent prognostic factors for DFS. Distant metastasis (HR=9.014; 95% CI: 2.303-38.914, p=0.004), LC (HR=0.091; 95% CI: 0.015-0.558, p=0.01), PC(HR=1.023; 95% CI: 1.006-1.041, p=0.009), PLR (HR=1.016; 95% CI: 1.004-1.027, p=0.002) and LMR (HR=0.58; 95% CI: 0.387-0.868, p=0.008) are significant independent prognostic factors for OS.ConclusionLow pre-treatment LMR and high PLR indicates poor survival in early tongue cancer. We suggested close followed for this subgroup despite radical resection with clear margin.



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