TY - JOUR
T1 - Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma
T2 - A Systematic Review and Meta-Analysis †
AU - Rodrigo, Juan P.
AU - Sánchez-Canteli, Mario
AU - Triantafyllou, Asterios
AU - de Bree, Remco
AU - Mäkitie, Antti A.
AU - Franchi, Alessandro
AU - Hellquist, Henrik
AU - Saba, Nabil F.
AU - Stenman, Göran
AU - Takes, Robert P.
AU - Valero, Cristina
AU - Zidar, Nina
AU - Ferlito, Alfio
N1 - Funding Information:
This study was supported by grants from the Plan Nacional de I+D+I 2013–2016 (ISCIII (PI19/00560 to J.P.R.), CIBERONC (CB16/12/00390 to J.P.R.), Ayudas a Grupos PCTI Principado de Asturias (IDI/2021/000079 to J.P.R.), and the FEDER Funding Program from the European Union.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - 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; p = 0.0006), for disease-free survival was 1.52 (95% CI 1.34–1.73; p < 0.00001), and for recurrence-free survival was 1.86 (95% CI 1.50–2.30; p < 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 (p = 0.0003), and in the HPV-negative subgroup 0.92 (95% CI 0.47–1.80; p = 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; p = 0.01), and for patients treated with surgery (±RT/CRT) was 1.72 (95% CI 1.08–2.72; p = 0.02). In conclusion, an elevated NLR relates to worse outcomes in patients with HPV-positive OPSCC.
AB - 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; p = 0.0006), for disease-free survival was 1.52 (95% CI 1.34–1.73; p < 0.00001), and for recurrence-free survival was 1.86 (95% CI 1.50–2.30; p < 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 (p = 0.0003), and in the HPV-negative subgroup 0.92 (95% CI 0.47–1.80; p = 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; p = 0.01), and for patients treated with surgery (±RT/CRT) was 1.72 (95% CI 1.08–2.72; p = 0.02). In conclusion, an elevated NLR relates to worse outcomes in patients with HPV-positive OPSCC.
KW - meta-analysis
KW - neutrophil-to-lymphocyte ratio
KW - oropharyngeal squamous cell carcinoma
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85147863013&partnerID=8YFLogxK
U2 - 10.3390/cancers15030802
DO - 10.3390/cancers15030802
M3 - Review article
AN - SCOPUS:85147863013
SN - 2072-6694
VL - 15
SP - 1
EP - 13
JO - Cancers
JF - Cancers
IS - 3
M1 - 802
ER -