Preoperative neutrophil-to-lymphocyte ratio predicts the prognosis of oral squamous cell carcinoma: a large-sample prospective study

Publication date: Available online 5 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Fa Chen, Lisong Lin, Lingjun Yan, Yu Qiu, Lin Cai, Baochang He
PurposeTo access and determine the prognostic value of preoperative the neutrophil to lymphocyte ratio (NLR) in patients with oral squamous cell carcinoma (OSCC).Patients and MethodsThe prospective study involving 1202 OSCC patients with surgical resection was carried out in Fujian, China. We performed two-stage analyses through randomly dividing all patients into 800 discovery and 402 replication sets. The optimal cutoff points of NLR were identified by X-tile program with the minimum P values. Prognostic factors were evaluated using univariate and multivariate Cox regression model.ResultsWe categorized the discovery set into low, middle and high risk groups based on optimal cutoff points of NLR (the NLR number were <1.94, 1.94-3.66, >3.66, respectively). High NLR was significantly associated with an increased risk of death on survival: the HRs were 1.51 (95% CI: 1.09-2.08) for patients with 1.99-3.66 NLR and 1.76 (95% CI: 1.21-2.55) for patients with >3.66 NLR. In the replication phase, we still found that patients in the high NLR values showed significantly worse overall survival compared with those with low NLR values(NLR number 1.94-3.66, HR: 1.61, 95%CI: 1.02-2.55; NLR >3.66, HR: 1.94, 95%CI: 1.16-3.27). Additionally, the better overall survival was observed in higher NLR patients who had received postoperative chemoradiotherapy (HR: 0.49, 95% CI: 0.26-0.92).ConclusionPreoperative NLR is an independent factor in predicting the prognosis of OSCC especially for patients with chemoradiotherapy, which may serve as a potential target for improving patients' prognosis.



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