Prognostic value of preoperative inflammatory ratios in early glottic cancer treated with transoral laser surgery

Abstract

Background: There is growing evidence regarding the prognostic utility of ratios such as Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammatory index (SIII) in head and neck squamous cell carcinoma (HNSCC). However, most studies to date include heterogeneous series with different treatments or tumor subsites. Methods: We collected data of 201 patients with stage I-II glottic squamous cell carcinoma treated with transoral laser surgery. NLR, PLR and SIII were calculated from preoperative cell blood count, cut-off points were obtained by ROC curve analysis, and survival rates were calculated. Results: High NLR (p=0.012) and SIII (p=0.037), but not PLR (p=0.48), were associated with worse disease-specific survival (DSS). Similar trend was observed with overall survival (OS), although did not reached statistical significance. On multivariable analyses, both high NLR (HR=3.8, 95%CI=1.5-9.9, p = 0.006) and high SIII (HR=2.77, 95%CI=1.1-6.9, p = 0.03) were significantly associated with shortened DSS. Conclusions: Preoperative NLR and SIII emerge as independent prognostic biomarkers for early-stage surgically treated glottic tumors and could guide individualized follow-up.