Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis



Rodrigo, Juan P, Sanchez-Canteli, Mario, Triantafyllou, Asterios, de Bree, Remco, Maekitie, Antti A, Franchi, Alessandro, Hellquist, Henrik, Saba, Nabil F, Stenman, Goeran, Takes, Robert P
et al (show 3 more authors) (2023) Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. CANCERS, 15 (3). 802-.

Access the full-text of this item by clicking on the Open Access link.
[thumbnail of Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma A Systematic Review and Meta-Analysis.pdf] PDF
Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma A Systematic Review and Meta-Analysis.pdf - Open Access published version

Download (2MB) | Preview

Abstract

Neutrophil-to-lymphocyte ratio (NLR) has been associated with survival in various cancers, including head and neck cancer. However, there is limited information on its role in oropharyngeal squamous cell carcinomas (OPSCC) according to HPV status. This prompted the present meta-analysis. Studies were selected when the prognostic value of NLR prior to treatment was evaluated in OPSCC patients, the cutoff value of NLR was available, and the prognostic value of NLR was evaluated by time-to-event survival analysis. A total of 14 out of 492 articles, including 7647 patients, were analyzed. The results showed a worse prognosis for the patients with a high NLR: The combined hazard ratios (HR) for overall survival (OS) in patients with an elevated NLR was 1.56 (95% confidence interval (CI) 1.21-2.02; <i>p</i> = 0.0006), for disease-free survival was 1.52 (95% CI 1.34-1.73; <i>p</i> < 0.00001), and for recurrence-free survival was 1.86 (95% CI 1.50-2.30; <i>p</i> < 0.00001). This worse prognosis of high NLR was exclusive of HPV-positive patients: HR for OS in the HPV-positive subgroup was 4.05 (95% CI 1.90-8.62 (<i>p</i> = 0.0003), and in the HPV-negative subgroup 0.92 (95% CI 0.47-1.80; <i>p</i> = 0.82). The prognosis of NLR was not influenced by treatment: The HR for OS for patients treated with radiotherapy/chemoradiotherapy (RT/CRT) was 1.48 (95% CI 1.09-2.01; <i>p</i> = 0.01), and for patients treated with surgery (±RT/CRT) was 1.72 (95% CI 1.08-2.72; <i>p</i> = 0.02). In conclusion, an elevated NLR relates to worse outcomes in patients with HPV-positive OPSCC.

Item Type: Article
Uncontrolled Keywords: oropharyngeal squamous cell carcinoma, meta-analysis, neutrophil-to-lymphocyte ratio, prognosis
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences > School of Dentistry
Depositing User: Symplectic Admin
Date Deposited: 17 May 2023 15:18
Last Modified: 17 May 2023 15:18
DOI: 10.3390/cancers15030802
Open Access URL: https://doi.org/10.3390/cancers15030802
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3170459