Prognostic Nomograms in Oral Squamous Cell Carcinoma: The Negative Impact of Low Neutrophil to Lymphocyte Ratio

Conclusions: In OSCC, very low preoperative NLR values have a negative prognostic impact on survival and recurrence, similarly to high ratios. ENE and perineural spread are the most important clinical-pathologic prognosticators. Introduction Oral squamous cell carcinoma (OSCC) accounts for more than 95% of oral tumors and is the eighth most frequent cancer worldwide, with an estimated incidence of 640,000 new cases per year (1). Survival of OSCC has slightly improved over the last 30 years, probably as a consequence of multimodal treatment spreading. However, intensified therapeutic regimens can result in significant toxicity and worsen the quality of life of survivors; thus, the definition of reliable prognostic factors is essential to properly stratify the risk of the individual patient and avoid undertreatment as well as unjustified toxicity. For this purpose, a nomogram is an effective way to combine several variables into a single user-friendly tool able to predict outcomes of interest for a given patient. Recently, a deeper insight on the role of the immune system in the process of cancerogenesis has shed light on the possible prognostic significance of markers of immune activation. Neutrophil to lymphocyte ratio (NLR, i.e., the ratio between the absolute number of circulating neutrophils and lymphocytes) is one of the most promising. An increased count of neutrophils can be considered a marker of tumor-induced systemic inflammation, while lymphocytopenia may ...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research