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Wang CC, Hsu MH, Lee CT, Chen CJ, Hwang TZ, Wang HP, Lin JT, Wang WL. Prognostic significances of systemic inflammatory response markers in patients with synchronous esophageal and head and neck cancers. Head Neck 2024; 46:1946-1955. [PMID: 38344911 DOI: 10.1002/hed.27677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Patients with head and neck squamous cell carcinoma (HNSCC) frequently develop synchronous esophageal cancer (ESCC), but there is a lack of clinical predictors. The neutrophil to lymphocyte (NLR), platelet to lymphocyte (PLR), and lymphocyte to monocyte ratios (LMRs), reflect the balance between pro-cancer inflammation and anti-cancer immune responses, but their role in HNSCC and synchronous cancer remain uncertain. METHOD The study consecutively enrolled a total of 717 patients with newly diagnosed HNSCC who received pre-treatment esophageal endoscopic screening. The pretreatment NLR, LMR and PLRs were calculated and analyzed in comparison with the clinical factors. RESULTS A total of 103 patients (14.4%) were found to have synchronous ESCCs, and were associated with a significantly lower absolute lymphocyte count (p < 0.001), higher NLRs (p = 0.044) and lower LMRs (p = 0.001), but not PLRs (p = 0.49). The ROC curve for the presence of synchronous ESCC verified the optimal cutoff value as 2.5 for NLRs and 4.0 for LMRs. Multivariable logistic regression revealed that a LMR <4 (OR 2.22; 95% CI 1.27-3.88, p = 0.005), alcohol consumption (OR 4.19; 95% CI 1.47-11.91, p = 0.007), tumor location over the pharynx (OR 1.68; 95% CI 1.07-2.64, p = 0.025), and low body mass index (OR 0.94; 95% CI 0.88-0.99, p = 0.039) were risk factors for developing synchronous ESCC. A low-LMR was significantly associated with decreases in overall survival (p < 0.0001), in both synchronous and non-synchronous groups. Multivariate analysis demonstrated that LMR <4 (HR 1.97; 95% CI 1.38-2.81, p < 0.001), a low-BMI (HR 0.96; 95% CI 0.93-0.99, p = 0.044) and presence of synchronous ESCC (HR 1.56; 95% CI 1.10-2.22, p = 0.013) were independent prognostic factors for HNSCC patients. CONCLUSION Incorporation of LMR into other identified risk factors, such as alcohol consumption, tumor location over pharynx, and low-BMI, may establish a more efficient screening program for esophageal exploration in HNSCC patients. The significances of LMR also suggest that anti-cancer immunity may play a role in the filed cancerization to initiate multiple cancers, and the immunotherapy may have potentials for prevention or as an adjuvant treatment for synchronous SCC in the future.
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Affiliation(s)
- Chih-Chun Wang
- Department of Otolaryngology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Ming-Hung Hsu
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Ching-Tai Lee
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Chi-Jen Chen
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Tzer-Zen Hwang
- Department of Otolaryngology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Hsiu-Po Wang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jaw-Town Lin
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Wen-Lun Wang
- Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Ohyama Y, Inaba Y, Kubota M, Kanemaru T, Hasegawa K. CT-assessed sarcopenia and prognostic nutritional index are associated with poor prognosis in oral squamous cell carcinoma. Oral Maxillofac Surg 2024; 28:659-666. [PMID: 37935816 DOI: 10.1007/s10006-023-01191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/29/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Recently, it has been reported that sarcopenia and nutritional evaluation are associated with the prognosis of patients with cancer; however, there are only a few detailed reports on oral cancer. This single-center retrospective study aimed to analyze the relationship between computed tomography (CT)-assessed sarcopenia (CT-SP), immunocompetence, nutritional status, and the prognosis of patients with oral squamous cell carcinoma (OSCC). METHODS This retrospective study included patients who underwent radical therapy with surgery for OSCC between January 2014 and January 2021. Skeletal muscle in the third cervical vertebra (C3) was measured using preoperative cervical CT, and the skeletal muscle index (SMI) was calculated. Nutritional status were investigated using blood tests. The correlation between each parameter and prognosis was analyzed. The primary predictor variables were SMI, ECOG performance status, BMI, and nutritional status. The primary outcome variable was the 5-year overall survival rate (OS) and the secondary outcome variable was 5-year disease-specific survival rate (DSS). RESULTS One hundred sixty-three patients were registered retrospectively. The number of patients with CT-SP was 76 (52%). In the univariate analysis, CT-SP, prognostic nutritional index (PNI), and lymphocyte-monocyte ratio (LMR) were associated with poor prognosis, with statistically significant differences in OS and DSS. In the multivariate analysis, only CT-SP was identified as an independent prognostic factor for DSS. CT-SP was significantly correlated with the PNI. CONCLUSION CT-SP was associated with a significant decrease in survival rate in patients with OSCC. Furthermore, CT-SP was correlated with the PNI.
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Affiliation(s)
- Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka, 420-8690, Japan.
| | - Yoshinori Inaba
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka, 420-8690, Japan
| | - Mako Kubota
- Department of Maxillofacial Surgery, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Tomoki Kanemaru
- Department of Maxillofacial Surgery, Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kazuki Hasegawa
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, 10-93, Outemachi, Aoi-ku, Shizuoka-shi, Shizuoka, 420-8690, Japan
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Sansa A, Valero C, Pujol A, Sauter B, Gayà J, Quer M, León X. Prognostic capacity of PIV (pan-immune-inflammation value) in patients with head and neck squamous cell carcinoma. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2024; 75:94-101. [PMID: 38220048 DOI: 10.1016/j.otoeng.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION The pan-immune-inflammation value (PIV), an index that results from the following ratio: (neutrophils × monocytes × platelets)/lymphocytes, has been proposed as a prognostic biomarker in different tumour models. The aim of this study is to analyse the prognostic capacity of PIV in patients with head and neck squamous cell carcinoma (HNSCC). PATIENTS AND METHODS Retrospective study of 1187 patients with HNSCC treated at our centre between 2000-2017. PIV value was obtained from an analysis performed within 3 weeks prior to the start of treatment. RESULTS PIV value was significantly associated with toxic consumption (0.001), tumour location (0.0001), tumour extension (0.0001), and histological grade (0.016). Four categories were defined based on PIV value using a recursive partitioning analysis: category I: PIV < 136.3 (n = 118, 9.9%), category II: PIV 136.3-451.1 (n = 594, 50.0%), category III: PIV 451.1-1,141.2 (n = 357, 30.1%), and category IV: PIV > 1141.2 (n = 118, 9.9%). A significant and ordered decrease in disease-specific survival was observed as the PIV category increased. This decrease in survival was independent of the type of treatment, tumour extension, or location of the primary tumour. The PIV category was and independent prognostic factor of disease-specific survival in a multivariable study. CONCLUSIONS PIV is a prognostic biomarker in patients with HNSCC.
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Affiliation(s)
- Aina Sansa
- Servicio de Otorrinolaringología, Hospital Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Cristina Valero
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Pujol
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Blanca Sauter
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julia Gayà
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Xavier León
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
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Kandathil SA, Peter Truta I, Kadletz-Wanke L, Heiduschka G, Stoiber S, Kenner L, Herrmann H, Huskic H, Brkic FF. Lymphocyte-to-Monocyte Ratio Might Serve as a Prognostic Marker in Young Patients with Tongue Squamous Cell Carcinoma. J Pers Med 2024; 14:159. [PMID: 38392590 PMCID: PMC10890051 DOI: 10.3390/jpm14020159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/21/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Young patients with tongue squamous cell carcinoma (TSCC) mostly lack typical prognostic markers and face a dire prognosis. The aim of this study was to analyze the prognostic relevance of lymphocyte-to-monocyte ratio (LMR) in TSCC patients, with a special emphasis on patients under 45 years. METHODS This retrospective study included all patients primarily treated for TSCC. The prognostic relevance of LMR was investigated in terms of predicting the overallsurvival (OS) and disease-free survival (DFS). RESULTS A total of 74 patients were included and the young cohort (<45 years) comprised 27 individuals. The mortality and recurrence rates were 39.2% (n = 29) and 37.8% (n = 28), respectively. OS and DFS were significantly shorter in the low LMR group within the whole cohort. Furthermore, low LMR was associated with worse prognosis, particularly inferior OS (median OS 1.7 vs. 14.6 years, p = 0.0156) and worse DFS (median DFS 0.8 years vs. not reached, p = 0.0405) in the young patient cohort. CONCLUSIONS Our results reveal that pretreatment LMR might become a prognostic tool for young TSCC patients, especially due to its availability. However, further studies on larger cohorts are necessary to validate our results.
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Affiliation(s)
- Sam Augustine Kandathil
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, 1090 Vienna, Austria
| | - Ina Peter Truta
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Lorenz Kadletz-Wanke
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Gregor Heiduschka
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Stoiber
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
- Christian Doppler Laboratory for Applied Metabolomics, 1090 Vienna, Austria
| | - Lukas Kenner
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
- Christian Doppler Laboratory for Applied Metabolomics, 1090 Vienna, Austria
- Center for Biomarker Research in Medicine, 8010 Graz, Austria
- Unit for Pathology of Laboratory Animals, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - Harald Herrmann
- Department of Radiation Oncology, Medical University of Vienna, 1090 Vienna, Austria
| | - Harun Huskic
- Department of Radiation Oncology, Medical University of Vienna, 1090 Vienna, Austria
| | - Faris F Brkic
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria
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Mireștean CC, Stan MC, Iancu RI, Iancu DPT, Bădulescu F. The Prognostic Value of Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio, and Monocyte-Lymphocyte Ratio in Head and Neck Squamous Cell Carcinoma (HNSCC)-A Retrospective Single Center Study and a Literature Review. Diagnostics (Basel) 2023; 13:3396. [PMID: 37998532 PMCID: PMC10670617 DOI: 10.3390/diagnostics13223396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and pallets-to-lymphocyte ratio (PLR) are currently validated as cheap and accessible biomarkers in different types of solid tumors, including head and neck cancers (HNC). THE PURPOSE OF THE STUDY To evaluate the possible purposes and biomarker value of NLR, PLR, and MLR recorded pre-treatment (radiotherapy/chemotherapy) in HNC. MATERIALS AND METHODS From 190 patients with HNC included in the oncology records in the oncology outpatient clinic of the Craiova County Emergency Hospital (from January 2002 to December 2022), 39 cases met the inclusion criteria (squamous cell carcinoma and the possibility to calculate the pre-treatment (chemotherapy/radiotherapy) value of NLR, PLR, and MLR. Overall survival (OS) values were correlated with NLR, PLR, and MLR. RESULTS The median values for NLR, PLR, and MLR were 6.15 (1.24-69), 200.79 (61.3-1775.0), and 0.53 (0.12-5.5), respectively. In the study, the mean values for NLR, PLR, and MLR of 2.88, 142.97, and 0.36, respectively, were obtained. The median OS in the study group was 11 months (1-120). Although a negative Pearson's correlation was present, the relationship between the variables was only weak, with values of R = 0.07, p = 0.67, R = 0.02, p = 0.31, and R = 0.07, p = 0.62 being related to NLR, PLR, and MLR, respectively, in correlation with OS. The median values of NLR, PLR, and MLR were calculated (1.53, 90.32, and 0.18, respectively) for the HNC cases with pre-treatment values of NLR < 2 and for the HNC cases with NLR values ≥ 6 (23.5, 232.78, and 0.79, respectively). The median OS for cases with NLR < 2 and NLR ≥ 6 were 17.4 and 13 months, respectively. CONCLUSIONS The comparative analysis of the data highlights a benefit to OS for cases low values of NLR. The role of not only borderline NLR values (between 2 and 6) as a prognostic marker in HNSCC but also the inclusion of PLR and MLR in a prognostic score must also be defined in the future. Prospective studies with more uniformly selected inclusion criteria could demonstrate the value of pre-treatment NLR, PLR, and MLR for treatment stratification through the intensification or de-escalation of non-surgical curative treatment in HNSCC.
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Affiliation(s)
- Camil Ciprian Mireștean
- Department of Medical Oncology and Radiotherapy, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (C.C.M.); (F.B.)
- Department of Surgery, Railways Clinical Hospital, 700506 Iasi, Romania
| | - Mihai Cosmin Stan
- Department of Surgery, Railways Clinical Hospital, 700506 Iasi, Romania
- Department of Medical Oncology, Vâlcea County Emergency Hospital, 200300 Râmnicu Vâlcea, Romania
| | - Roxana Irina Iancu
- Faculty of Dental Medicine, Oral Pathology Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Department of Clinical Laboratory, “Saint Spiridon” County Hospital, 700111 Iasi, Romania
| | - Dragoș Petru Teodor Iancu
- Oncology and Radiotherapy Department, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Department of Radiation Oncology, Regional Institute of Oncology, 700483 Iași, Romania
| | - Florinel Bădulescu
- Department of Medical Oncology and Radiotherapy, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; (C.C.M.); (F.B.)
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Trevisani LFM, Kulcsar IF, Kulcsar MAV, Dedivitis RA, Kowalski LP, Matos LL. Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:5245. [PMID: 37958419 PMCID: PMC10649982 DOI: 10.3390/cancers15215245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Oral squamous cell carcinoma (OSCC) remains a significant public health concern. The variables utilized to determine appropriate treatment for this disease also represent its most unfavorable prognostic factors, with these parameters solely determined by the neoplasm and its behavior. However, a lack of well-established indices is evident in the literature that specifically relate to the patient and indicate a worse prognosis. OBJECTIVE To assess the prognostic impact of hematological indices in patients with OSCC. METHODS This retrospective cohort study included patients with oral squamous cell carcinoma (OSCC) who underwent curative-intent treatment. Treatment encompassed surgery, followed by adjuvant therapy, as necessary. Laboratory tests were conducted immediately prior to surgery, and demographic information was obtained from medical records. RESULTS The cohort comprised 600 patients, with 73.5% being male subjects. Adjuvant treatment was recommended for 60.3% of patients. Throughout the follow-up period, 48.8% of participants died. Univariate analysis indicated that perineural invasion, angiolymphatic invasion, pT4 tumors, lymph node metastases, extranodal extravasation, RDW > 14.3%, NLR (neutrophil-lymphocyte ratio) > 3.38, PLR (platelet-lymphocyte ratio) > 167.3, and SII (systemic inflammatory/immune response index) > 416.1 were factors associated with increased mortality. These threshold values were established through ROC curve analysis. In the multivariate analysis, angiolymphatic invasion (HR = 1.43; 95% CI: 1.076-1.925; p = 0.014), pT4a/b tumors (HR = 1.761; 95% CI: 1.327-2.337; p < 0.001), extranodal extravasation (HR = 1.420; 95% CI: 1.047-1.926; p = 0.024), and RDW (HR = 1.541; 95% CI: 1.153-2.056; p = 0.003) were identified as independent risk factors for decreased overall survival. CONCLUSIONS RDW > 14.3% was proven to be a reliable parameter for assessing overall survival in patients with OSCC. Further studies are required to evaluate the clinical applicability of other hematological indices.
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Affiliation(s)
- Lorenzo Fernandes Moça Trevisani
- Programa de Pós-Graduação em Anestesiologia, Ciências Cirúrgicas e Medicina Perioperatória, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-903, Brazil;
| | - Isabelle Fernandes Kulcsar
- Instituto do Câncer do Estado de São Paulo (Icesp), Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
| | - Marco Aurélio Vamondes Kulcsar
- Head and Neck Surgery Department, Instituto do Câncer do Estado de São Paulo (Icesp), Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
| | - Rogerio Aparecido Dedivitis
- Head and Neck Surgery Department, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
| | - Leandro Luongo Matos
- Head and Neck Surgery Department, Instituto do Câncer do Estado de São Paulo (Icesp), Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
- Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo 05652-000, Brazil
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Wei D, Liu J, Ma J. The value of lymphocyte to monocyte ratio in the prognosis of head and neck squamous cell carcinoma: a meta-analysis. PeerJ 2023; 11:e16014. [PMID: 37719125 PMCID: PMC10501369 DOI: 10.7717/peerj.16014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/10/2023] [Indexed: 09/19/2023] Open
Abstract
Objectives Although lymphocyte-monocyte ratio (LMR) is a potential prognostic biomarker in many tumor indications, a doubt occurs around its association with head and neck squamous cell carcinoma (HNSCC). We aimed to evaluate the predictive value of LMR in patients with HNSCC. Methods We searched PubMed, Web of Science, EMBASE, and the Cochrane database from inception to May 8, 2023 for systematic review and meta-analysis on LMR and outcomes related to HNSCC development. STATA software was used to estimate the correlation between LMR and prognosis. The risk ratio (hazard ratio, HR) and 95% confidence interval l (CI) for overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS), and progression-free survival (PFS) were calculated, and the association between LMR and OS was further validated by subgroup analysis. The source of heterogeneity with the results of subgroup analysis was analyzed by meta-regression analysis. This meta-analysis was registered at PROSPERO (CRD42023418766). Results After a comprehensive exploration, the results of 16 selected articles containing 5,234 subjects were evaluated. A raised LMR was connected to improved OS (HR = 1.36% CI [1.14-1.62] P = 0.018), DFS (HR = 0.942, 95% CI [0.631-1.382], P = 0.02), and PFS (HR = 0.932, 95% CI [0.527-1.589], P < 0.022). Subgroup analysis indicated that patients with a low LMR level had a poor prognosis with a critical value of ≥4. The LMR was found to be prognostic for cases with an LMR of <4. The meta-regression analysis showed that the cut-off values and treatment methods were the primary sources of high heterogeneity in patients with HNSCC. Conclusions Our study suggested that an elevated LMR is a potential prognostic biomarker in patients with HNSCC and could be used to predict patient outcomes.
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Affiliation(s)
- Deyou Wei
- Department of Otolaryngology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Jiajia Liu
- Department of Otolaryngology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Jipeng Ma
- Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
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Atasever Akkas E, Erdis E, Yucel B. Prognostic value of the systemic immune-inflammation index, systemic inflammation response index, and prognostic nutritional index in head and neck cancer. Eur Arch Otorhinolaryngol 2023; 280:3821-3830. [PMID: 37029321 DOI: 10.1007/s00405-023-07954-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/28/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE This study sought to investigate the prognostic value of the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and prognostic nutritional index (PNI) in patients with head and neck cancer. METHODS The data of 310 patients with head and neck cancer who were referred to the Radiation Oncology Clinic of Sivas Cumhuriyet University Faculty of Medicine (n = 271, 87%) and to S.B.U. Dr. Abdurrahman Yurtaslan Ankara Oncology Health Practice and Research Centre (n = 39, 13%) between January 2009 and March 2020 were retrospectively analysed. At the time of diagnosis, patients' neutrophil, lymphocyte, monocyte, platelet and albumin levels were used to calculate their SII, SIRI and PNI indices. RESULTS Multivariate analysis found the after variables to be independent prognostic factors for overall survival (OS): SII [hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.18-2.47; p = 0.002] and PNI (HR 0.66, 95% CI 0.43-0.97; p = 0.038), stage (HR 2.11, 95% CI 1.07-4.16; p = 0.030), fraction technique (HR 0.49, 95% CI 0.28-0.85; p = 0.011) and age (HR 2.51, 95% CI 1.77-3.57; p = 0.001).The following variables were found to be independent prognostic factors for disease-free survival (DFS) in multivariate analysis: SII (HR 2.16, 95% CI 1.22-3.83; p = 0.008), fractionation technique (HR 0.17, 95% CI 0.004-0.64; p = 0.017) and age (HR 2.11, 95% CI 1.13-3.93; p = 0.019). CONCLUSION This study found a high SII to be an independent poor prognostic factor for both OS and DFS, while a low PNI was found to be an independent poor prognostic factor only for OS.
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Affiliation(s)
- Ebru Atasever Akkas
- Department of Radiation Oncology, Medical Faculty of Saglik Bilimleri University, Dr. Abdurrahman Yurtarslan Oncology Research and Training Hospital, Ankara, Turkey.
| | - Eda Erdis
- Department of Radiation Oncology, Medical Faculty of Cumhuriyet University, Sivas, Turkey
| | - Birsen Yucel
- Department of Radiation Oncology, Medical Faculty of Cumhuriyet University, Sivas, Turkey
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Yu B, Ma SJ, Khan M, Gill J, Iovoli A, Fekrmandi F, Farrugia MK, Wooten K, Gupta V, McSpadden R, Kuriakose MA, Markiewicz MR, Al-Afif A, Hicks WL, Seshadri M, Ray AD, Repasky EA, Singh AK. Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation. BMC Cancer 2023; 23:572. [PMID: 37344761 DOI: 10.1186/s12885-023-11062-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Given the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer. METHODS A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias. RESULTS A total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8-74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82-0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72-0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12-2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08-2.63, p = 0.02). CONCLUSION Low LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions.
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Affiliation(s)
- Brian Yu
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Sung Jun Ma
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Michael Khan
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Jasmin Gill
- University at Buffalo, The State University of New York, 12 Capen Hall, Buffalo, NY, 14260, USA
| | - Austin Iovoli
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Fatemeh Fekrmandi
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Mark K Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Kimberly Wooten
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Vishal Gupta
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Ryan McSpadden
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Moni A Kuriakose
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY, 14214, USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Ayham Al-Afif
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Wesley L Hicks
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Mukund Seshadri
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Andrew D Ray
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Elizabeth A Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Anurag K Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA.
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Yang C, Garg R, Fredenburg K, Weidert F, Mendez-Gomez H, Amdur R, Lee JH, Ku J, Kresak J, Staras S, Sikora AG, Wang L, McGrail D, Mitchell D, Sayour E, Silver N. Association of Suppressive Myeloid Cell Enrichment with Aggressive Oropharynx Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:2346. [PMID: 37190274 PMCID: PMC10136648 DOI: 10.3390/cancers15082346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/22/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND While immune-cell infiltrated tumors, such as human papillomavirus positive (HPV+) ororpharyngeal squamous cell carcinomas (OPSCC) have been associated with an improved clinical prognosis, there is evidence to suggest that OPSCCs are also subjected to increased immunoregulatory influence. The objective of this study was to assess whether patients with clinically aggressive OPSCC have a distinct immunosuppressive immune signature in the primary tumor. METHODS This retrospective case-control study analyzed 37 pre-treatment tissue samples from HPV+ and HPV-negative OPSCC patients treated at a single institution. The cases were patients with known disease recurrence and the controls were patients without disease recurrence. An mRNA-expression immune-pathway profiling was performed, and correlated to clinical outcomes. The TCGA head and neck cancer database was utilized to make comparisons with the institutional cohort. RESULTS In our cohort, HPV-negative and HPV+ patients with known disease recurrence both had significantly increased suppressive monoctyte/macrophage and granulocyte cell-expression-profile enrichment. Similar findings were found in the TCGA cohort when comparing HPV-negative to positive patients. CONCLUSIONS our study demonstrates that patients with recurrent HPV+ OPSCC had suppressive monocyte/macrophage and granulocyte immune-cell enrichment, similar to those seen in the more aggressive HPV-negative OPSCC.
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Affiliation(s)
- Changlin Yang
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Rekha Garg
- Department of Pediatrics, University of Florida, Gainesville, FL 32603, USA
| | | | - Frances Weidert
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Hector Mendez-Gomez
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Robert Amdur
- Department of Radiation Oncology, University of Florida, Gainesville, FL 32608, USA
| | - Ji-Hyun Lee
- Department of Biostatistics, University of Florida, Gainesville, FL 32603, USA
| | - Jamie Ku
- Head and Neck Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Jesse Kresak
- Department of Pathology, University of Florida, Gainesville, FL 32610, USA
| | - Stephanie Staras
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA
| | - Andrew G. Sikora
- Department of Head and Neck Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, USA
| | - Lily Wang
- Translational Hematology and Oncology, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Daniel McGrail
- Lerner Research Institute, Cleveland Clinic, Center of Immunotherapy and Precision Immuno-Oncology, Cleveland, OH 44106, USA
| | - Duane Mitchell
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Elias Sayour
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Natalie Silver
- Head and Neck Institute, Cleveland Clinic, Cleveland, OH 44106, USA
- Lerner Research Institute, Cleveland Clinic, Center of Immunotherapy and Precision Immuno-Oncology, Cleveland, OH 44106, USA
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11
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Sakai A, Iijima H, Ebisumoto K, Yamauchi M, Teramura T, Yamazaki A, Watanabe T, Inagi T, Maki D, Okami K. Prognostic Value of Inflammatory and Nutritional Biomarkers of Immune Checkpoint Inhibitor Treatment for Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck. Cancers (Basel) 2023; 15:cancers15072021. [PMID: 37046684 PMCID: PMC10093403 DOI: 10.3390/cancers15072021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
This study aimed to determine the prognostic value of inflammatory and nutritional biomarkers of immune checkpoint inhibitor (ICI) therapy for recurrent or metastatic squamous cell carcinoma of the head and neck (RMHNSCC) and to identify the most useful factor for prognosis assessment. We retrospectively reviewed the medical records of patients with RMHNSCC who received ICI therapy. The response rate for ICI therapy and the relationship between inflammatory and nutritional biomarkers and overall survival were examined. The included biomarkers did not correlate with an objective response rate but were associated with a disease control rate. Univariate analysis showed significant correlations between the serum albumin level, C-reactive protein level, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio (LMR), systemic immune-inflammation index, and controlling the nutritional status score and overall survival; multivariate analysis showed that LMR was significantly correlated with overall survival. LMR was the most important biomarker according to the machine learning model. This study suggests that LMR may be the most useful biomarker for predicting the prognosis of ICI treatment for RMHNSCC.
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12
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Salazar-Valdivia FE, Valdez-Cornejo VA, Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcón-Braga EA, Mosquera-Rojas MD, Garrido-Matta DP, Herrera-Añazco P, Benites-Zapata VA, Hernandez AV. Systemic Immune-Inflammation Index and Mortality in Testicular Cancer: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:diagnostics13050843. [PMID: 36899987 PMCID: PMC10000460 DOI: 10.3390/diagnostics13050843] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/25/2023] Open
Abstract
The systemic immune-inflammation index (SIII) is a marker studied in multiple types of urologic cancer. This systematic review evaluates the association between SIII values with overall survival (OS) and progression-free survival (PFS) in testicular cancer. We searched observational studies in five databases. The quantitative synthesis was performed using a random-effects model. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The only measure of the effect was the hazard ratio (HR). A sensitivity analysis was performed according to the risk of bias in the studies. There were 833 participants in a total of 6 cohorts. We found that high SIII values were associated with worse OS (HR = 3.28; 95% CI 1.3-8.9; p < 0.001; I2 = 78) and PFS (HR = 3.9; 95% CI 2.53-6.02; p < 0.001; I2 = 0). No indication of small study effects was found in the association between SIII values and OS (p = 0.5301). High SIII values were associated with worse OS and PFS. However, further primary studies are suggested to enhance the effect of this marker in different outcomes of testicular cancer patients.
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Affiliation(s)
- Farley E. Salazar-Valdivia
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | - Valeria A. Valdez-Cornejo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | | | - Enrique A. Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo 13011, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | - Esteban A. Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | - Melany D. Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | | | - Percy Herrera-Añazco
- Escuela de Medicina, Universidad Privada San Juan Bautista, Lima 15067, Peru
- Universidad Privada del Norte, Trujillo 13011, Peru
| | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 14072, Peru
- Correspondence: ; Tel.: +51-1-3171000
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta-análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15012, Peru
- Health Outcomes, Policy, and Evidence Synthesis Group, University of Connecticut School of Pharmacy, Mansfield, CT 06269, USA
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13
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Sansa A, Valero C, Holgado A, Vásquez R, Quer M, Patel SG, León X. External validation of the H-index (host index) in patients with head and neck squamous cell carcinomas. Head Neck 2023; 45:178-186. [PMID: 36225167 DOI: 10.1002/hed.27224] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/22/2022] [Accepted: 10/04/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The aim of the current study is to perform an external validation of the prognostic capacity of the H-index in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Retrospective study of 835 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx, or larynx. RESULTS When applying the cutoffs proposed in the original description of the H-index (1.5 and 3.5), we observed an orderly and significant decrease in the disease-specific survival and overall survival as H-index increased. Additionally, we were able to observe a decrease in survival as the H-index increased regardless of the location, the extension of the tumor or the type of treatment performed. CONCLUSION We have validated the prognostic capacity of the H-index in patients with HNSCC regardless of the location of the primary tumor, the extent of the disease, or the type of treatment performed.
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Affiliation(s)
- Aina Sansa
- Department of Otorhinolaryngology, Hospital Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Cristina Valero
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Anna Holgado
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosselin Vásquez
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Snehal G Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Xavier León
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,UVIC-Universitat Central de Catalunya, Vic, Spain
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14
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Dotto-Vasquez G, Villacorta-Ampuero AK, Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcón-Braga EA, Herrera-Añazco P, Benites-Zapata VA, Hernandez AV. Lymphocyte-to-Monocyte Ratio and Clinical Outcomes in Cholangiocarcinoma: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:2655. [PMID: 36359498 PMCID: PMC9689307 DOI: 10.3390/diagnostics12112655] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
Lymphocyte-to-Monocyte ratio (LMR) has shown an association with survival outcomes in several oncological diseases. This study aimed to evaluate the association between LMR and clinical outcomes for cholangiocarcinoma patients. A systematic review and meta-analysis were performed to assess the association between LMR values and overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and time to recurrence (TTR) in cholangiocarcinoma patients. We used Hazard ratio (HR) and their 95% confidence interval (CI) as a measure of effect for the random effect model meta-analysis. The Newcastle-Ottawa Scale was used for quality assessment. The Egger test and funnel plot were developed for approaching publication bias. A total of 19 studies were included in this study (n = 3860). The meta-analysis showed that cholangiocarcinoma patients with low values of LMR were associated with worse OS (HR: 0.82; 95% CI: 0.71-0.96; I2 = 86%) and worse TTR (HR: 0.71; 95% CI: 0.58-0.86; I2 = 0%). DFS and RFS also were evaluated; however, they did not show statistically significant associations. Low LMR values were associated with a worse OS and TTR.
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Affiliation(s)
| | | | | | - Enrique A. Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo 13011, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | - Esteban A. Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | - Percy Herrera-Añazco
- Escuela de Enfermería, Universidad Privada San Juan Bautista, Lima 15067, Peru
- Instituto de Evaluación de Tecnologías en Salud e Investigación—IETSI, EsSalud, Lima 14072, Peru
| | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 14072, Peru
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta-análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15012, Peru
- Health Outcomes, Policy, and Evidence Synthesis Group, University of Connecticut School of Pharmacy, Mansfield, CT 06269, USA
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15
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Ruiz-Ranz M, Lequerica-Fernández P, Rodríguez-Santamarta T, Suárez-Sánchez FJ, López-Pintor RM, García-Pedrero JM, de Vicente JC. Prognostic implications of preoperative systemic inflammatory markers in oral squamous cell carcinoma, and correlations with the local immune tumor microenvironment. Front Immunol 2022; 13:941351. [PMID: 35958590 PMCID: PMC9360320 DOI: 10.3389/fimmu.2022.941351] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/15/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to investigate the prognostic significance of preoperative inflammatory markers in peripheral blood of patients with oral squamous cell carcinoma (OSCC), and to establish correlations with the infiltrate of macrophages and lymphocytes in the local immune tumor microenvironment (TME). Materials and Methods Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and systemic immune-inflammation index (SII) were retrospectively evaluated in a cohort of 348 OSCC patients, and correlated with overall (OS) and disease-specific survival (DSS). Immunohistochemical analysis of tumoral and stromal infiltration of CD8+, CD4+, FOXP3+ and CD20+ lymphocytes and CD68+ and CD163+ macrophages was performed in a subset of 119 OSCC patient samples, and correlations further assessed. Results NLR, SII, and LMR were significantly associated with a poorer OS in univariate analysis; however, only NLR remained a significant independent predictor in the multivariate analysis (HR = 1.626, p = 0.04). NLR and SII were inversely and significantly correlated with stromal infiltration of CD8+, CD4+, and CD20+ lymphocytes. Moreover, a significant correlation between LMR was also found to significantly associate with stromal infiltration of CD8+, CD4+, and CD20+ lymphocytes, stromal CD68+ and CD163+ macrophages, and also tumoral infiltration of CD4+ and CD20+ lymphocytes. Conclusions Preoperative NLR, SII, and LMR may serve as valuable systemic markers to predict OSCC patient survival, with NLR emerging as an independent predictor of poor OS. Moreover, strong significant correlations were exclusively observed between systemic inflammatory markers and the local stromal infiltration of lymphocytes in the TME.
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Affiliation(s)
- Marta Ruiz-Ranz
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Paloma Lequerica-Fernández
- Department of Biochemistry, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | - Tania Rodríguez-Santamarta
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | | | - Rosa M. López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Juana M. García-Pedrero
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Department of Otolaryngology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Juan C. de Vicente, ; Juana M. García-Pedrero,
| | - Juan C. de Vicente
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain
- Department of Surgery, University of Oviedo, Oviedo, Spain
- *Correspondence: Juan C. de Vicente, ; Juana M. García-Pedrero,
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16
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Meng X, Wang X, Jiang C, Zhang S, Cheng S. Correlation analysis of lymphocyte-monocyte ratio with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer. Transl Oncol 2022; 18:101355. [PMID: 35121221 PMCID: PMC8818569 DOI: 10.1016/j.tranon.2022.101355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 01/12/2023] Open
Abstract
We evaluated the impact of LMR on pCR and prognosis in breast cancer patients. High LMR predicts increased pCR in HER2(+) breast cancer patients. High LMR predicts a better prognosis in neoadjuvant chemotherapy patients. LMR is an economical and easy detection index for patients.
Purpose Inflammation plays an important role in tumor proliferation, metastasis, and chemotherapy resistance. Peripheral blood lymphocyte-monocyte ratio (LMR) has been reported to be closely associated with the prognosis of many tumors, such as certain hematologic malignancies and gastric cancer. However, the association in breast cancer is still not clear. This study investigated the relationship between LMR with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer, to provide convenient and accurate predictive indicators for pathological complete response (pCR) and prognosis. Methods The clinicopathological data of 192 female breast cancer patients who received neoadjuvant chemotherapy and surgery in Harbin Medical University Tumor Hospital from January 2013 to August 2017 were retrospectively analyzed. Blood lymphocytes and monocytes were obtained by peripheral venous punctures. Results Compared with the low LMR group, pCR was more easily obtained in the high LMR group (P=0.020); Subgroup analysis showed that patients with the high LMR and HER-2(+) group were more likely to obtain pCR (P=0.011).Univariate andmultivariate results showed that the overall survival (OS) and disease free survival (DFS) of the high LMR group were longer than that of the low LMR group. Conclusion LMR and HER-2 status are correlated with pCR of neoadjuvant chemotherapy in breast cancer patients and are independent predictors of pCR after neoadjuvant chemotherapy in breast cancer patients. Meanwhile, both LMR and T stage of tumor are independent prognostic factors of breast cancer patients, with good predictive value.
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Affiliation(s)
- Xiangyu Meng
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Xueying Wang
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Cong Jiang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Shuai Zhang
- The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Shaoqiang Cheng
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China.
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Yang B, Eliot M, McClean MD, Waterboer T, Pawlita M, Butler R, Nelson HH, Langevin SM, Christensen BC, Kelsey KT. DNA methylation-derived systemic inflammation indices and their association with oropharyngeal cancer risk and survival. Head Neck 2022; 44:904-913. [PMID: 35048488 DOI: 10.1002/hed.26981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Head and neck squamous cell carcinomas are associated with systemic inflammation (SI). We evaluated whether DNA methylation-derived SI (mdSI) indices are associated with oropharyngeal cancer risk and survival. METHODS Ninety-four oropharyngeal squamous cell carcinoma (OPSCC) cases and 57 controls with DNA methylation data were included. Logistic regression analysis and survival analysis were performed to test the association of mdSI indices with OPSCC risk and survival. RESULTS Higher methylation-derived neutrophil-to-lymphocyte ratio (mdNLR) was associated with increased risk of OPSCC (OR = 1.21, 95%CI: 1.11-1.40) while no association was found with methylation-derived lymphocyte-to-monocyte ratio (mdLMR). For 5-year overall survival, higher mdLMR was significantly associated with decreased risk of death (HR = 0.25, 95%CI: 0.10-0.64) while the converse was observed for mdNLR (HR = 2.48, 95%CI: 1.04-5.92). CONCLUSION We observed an association between mdSI indices and OPSCC risk and 5-year overall survival. It is possible to use mdLMR as an independent prognostic factor for OPSCC.
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Affiliation(s)
- Bo Yang
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Melissa Eliot
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Tim Waterboer
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rondi Butler
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Heather H Nelson
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott M Langevin
- Department of Environmental & Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Brock C Christensen
- Department of Epidemiology, Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.,Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Karl T Kelsey
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA.,Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, USA
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Bernardinello N, Grisostomi G, Cocconcelli E, Castelli G, Petrarulo S, Biondini D, Saetta M, Spagnolo P, Balestro E. The clinical relevance of lymphocyte to monocyte ratio in patients with Idiopathic Pulmonary Fibrosis (IPF). Respir Med 2021; 191:106686. [PMID: 34847517 DOI: 10.1016/j.rmed.2021.106686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023]
Abstract
Disease course in Idiopathic Pulmonary Fibrosis (IPF) is highly heterogeneous and markers of disease progression would be helpful. Blood leukocyte count has been studied in cancer patients and a reduced lymphocyte to monocyte ratio (LMR) has been show to predict survival. Thus, we aimed to investigate the role of monocytes count and LMR in three distinct population of patients with IPF: 77 newly-diagnosed IPF, 40 with end-stage IPF and 17 IPF with lung cancer. In newly-diagnosed IPF patients, we observed a negative correlation between forced vital capacity (FVC) at diagnosis and both white blood cells and monocytes count (r = -0.24; p = 0.04 and r = -0.27; p = 0.01; respectively). Moreover, a high monocytes count was independently associated with functional decline (OR: 1.004, 95%CI 1.00-1.01; p = 0.03). In newly-diagnosed IPF, the LMR cut-off at diagnosis was 4.18 with an AUC of 0.67 (95%CI 0.5417-0.7960; p = 0.025), and overall survival was significantly worse in patients with a LMR<4.18 compared to patients with a LMR≥4.18 (HR: 6.88, 95%CI 2.55-18.5; p = 0.027). LMR was significantly lower in IPF patients with lung cancer compared to those newly diagnosed with IPF [2.2 (0.8-4.4), 3.5 (0.8-8.8); p < 0.0001] and those with end-stage disease [3.6 (2-6.5); p < 0.0001]. In conclusion, a LMR<4.18 is associated with significantly shorter survival in newly-diagnosed IPF patients. In addition, LMR is significantly lower in patients with IPF and lung cancer compared to patients with newly-diagnosed IPF. High monocytes count at baseline negatively correlates with FVC and is an independent predictor of disease progression in newly-diagnosed IPF patients.
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Affiliation(s)
- Nicol Bernardinello
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Giulia Grisostomi
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Elisabetta Cocconcelli
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Gioele Castelli
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Simone Petrarulo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Davide Biondini
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Marina Saetta
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Paolo Spagnolo
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy
| | - Elisabetta Balestro
- Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Via Giustiniani 2, 35128; University of Padova, Padova, Italy.
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The lymphocyte/monocyte ratio and red blood cell transfusion during radical retropubic prostatectomy. J Anesth 2021; 36:68-78. [PMID: 34623495 PMCID: PMC8497187 DOI: 10.1007/s00540-021-03008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 09/29/2021] [Indexed: 12/04/2022]
Abstract
Purpose Despite improvements of strategy in radical retropubic prostatectomy, blood loss is still a major concern. The lymphocyte/monocyte (LM) ratio is a prognostic indicator for various diseases. We identified the risk factors, including the LM ratio, for red blood cell (RBC) transfusion during radical retropubic prostatectomy. Methods This retrospective study assessed patients who underwent radical retropubic prostatectomy between March 2009 and December 2020. To determine the risk factors for RBC transfusion, a multivariate logistic regression analysis was conducted. A receiver operating characteristic (ROC) curve analysis was also performed. Postoperative outcomes, including acute kidney injury (AKI), hospitalization duration, and intensive care unit (ICU) admission, were also evaluated. Results Among 1302 patients, 158 patients (12.1%) received an intraoperative RBC transfusion. Multivariate logistic regression analysis demonstrated that the risk factors for RBC transfusion were the LM ratio, hemoglobin, 6% hydroxyethyl starch amount, and positive surgical margin. The area under the ROC curve of LM ratio was 0.706 (cut-off = 4.3). The LM ratio at ≤ 4.3 was significantly related to transfusion in multivariate-adjusted analysis (odds ratio = 4.598, P < 0.001). AKI and ICU admission were significantly higher, and the hospitalization duration was significantly longer in patients with RBC transfusion. Conclusions The LM ratio was a risk factor for RBC transfusion in radical retropubic prostatectomy. The optimal cut-off value of the LM ratio to predict transfusion was 4.3. RBC transfusion was associated with poor postoperative outcomes. Therefore, our results suggest that the LM ratio provide useful information on RBC transfusion in radical retropubic prostatectomy.
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Kumarasamy C, Tiwary V, Sunil K, Suresh D, Shetty S, Muthukaliannan GK, Baxi S, Jayaraj R. Prognostic Utility of Platelet-Lymphocyte Ratio, Neutrophil-Lymphocyte Ratio and Monocyte-Lymphocyte Ratio in Head and Neck Cancers: A Detailed PRISMA Compliant Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13164166. [PMID: 34439320 PMCID: PMC8393748 DOI: 10.3390/cancers13164166] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023] Open
Abstract
Simple Summary Inflammation plays a major role in cancer development and progression and has the potential to be used as a prognostic marker in cancer. Previous studies have attempted to evaluate PLR, NLR and MLR as indicators of inflammation/prognostic markers in cancer, but there is no common consensus on its application in clinical practice. The aim of this systematic review and meta-analysis (a) assess the prognostic efficacy of all three prognostic markers in comparison to each other and, (b) investigate the prognostic potential of these three markers in HNC. The study followed PRISMA guidelines, with literature being collated from multiple bibliographic databases. Preliminary and secondary screening were carried out using stringent inclusion/exclusion criteria. Abstract Inflammation plays a major role in cancer development and progression and has the potential to be used as a prognostic marker in cancer. Previous studies have attempted to evaluate Platelet-to-lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR) or monocyte–lymphocyte ratio (MLR) as indicators of inflammation/prognostic markers in cancer, but there is no common consensus on their application in clinical practice. The aim of this systematic review and meta-analysis is to (a) assess the prognostic efficacy of all three prognostic markers in comparison to each other and (b) investigate the prognostic potential of these three markers in HNC. The study followed PRISMA guidelines, with the literature being collated from multiple bibliographic databases. Preliminary and secondary screening were carried out using stringent inclusion/exclusion criteria. Meta-analysis was carried out on selected studies using CMA software and HR as the pooled effect size metric. A total of 49 studies were included in the study. The pooled HR values of PLR, NLR and MLR indicated that they were significantly correlated with poorer OS. The pooled effect estimates for PLR, NLR and MLR were 1.461 (95% CI 1.329–1.674), 1.639 (95% CI 1.429–1.880) and 1.002 (95% CI 0.720–1.396), respectively. Significant between-study heterogeneity was observed in the meta-analysis of all three. The results of this study suggest that PLR, NLR and MLR ratios can be powerful prognostic markers in head and neck cancers that can guide treatment. Further evidence from large-scale clinical studies on patient cohorts are required before they can be incorporated as a part of the clinical method. PROSPERO Registration ID: CRD42019121008
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Affiliation(s)
- Chellan Kumarasamy
- School of Health and Medical Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Vaibhav Tiwary
- School of Biosciences and Technology, Vellore Institute of Technology (VIT), Vellore 632014, India; (V.T.); (G.K.M.)
| | - Krishnan Sunil
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Deepa Suresh
- Division of Endocrinology, Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Sameep Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, A Constituent of MAHE, Manipal 576104, India;
| | | | - Siddhartha Baxi
- Radiation Oncology, Genesiscare Gold Coast, John Flynn Hospital, 42 Inland Drive, Tugun, QLD 4224, Australia;
| | - Rama Jayaraj
- Northern Territory Institute of Research and Training, Darwin, NT 0909, Australia
- Correspondence:
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21
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Saroul N, Puechmaille M, Lambert C, Hassan AS, Biau J, Lapeyre M, Mom T, Bernadach M, Gilain L. Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status. Otolaryngol Head Neck Surg 2021; 166:118-127. [PMID: 33845660 DOI: 10.1177/01945998211004592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. STUDY DESIGN Single-center retrospective study of prospectively collected data. SETTING Tertiary referral center. METHODS Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. RESULTS In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. CONCLUSION Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.
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Affiliation(s)
- Nicolas Saroul
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Mathilde Puechmaille
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Achraf Sayed Hassan
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Julian Biau
- Radiation Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Michel Lapeyre
- Radiation Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Thierry Mom
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Maureen Bernadach
- Medical Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Laurent Gilain
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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22
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De Keukeleire SJ, Vermassen T, Hilgert E, Creytens D, Ferdinande L, Rottey S. Immuno-Oncological Biomarkers for Squamous Cell Cancer of the Head and Neck: Current State of the Art and Future Perspectives. Cancers (Basel) 2021; 13:1714. [PMID: 33916646 PMCID: PMC8038541 DOI: 10.3390/cancers13071714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/24/2022] Open
Abstract
The era of immune checkpoint inhibitors has altered the therapeutic landscape in squamous cell cancer of the head and neck (SCCHN). Our knowledge about the tumor microenvironment has fueled the research in SCCHN, leading to several well-known and less-known prognostic and predictive biomarkers. The clinical staging, p16/HPV status, and PD-L1 expression are currently the main tools for assessing the patients' diagnosis and prognosis. However, several novel biomarkers have been thoroughly investigated, some reaching actual significant clinical contributions. The untangling of the immune infiltrate with the subtyping of tissue-associated tumor infiltrating lymphocytes, tumor-associated macrophages, and circulating blood-based biomarkers are an interesting avenue to be further explored and prospectively assessed. Although PD-L1 expression remains the most important response predictor for immune checkpoint inhibitors, several flaws impede proper assessment such as technical issues, different scoring protocol, and intra-, inter-, and temporal heterogeneity. In addition, the construction of an immune-related gene panel has been proposed as a prognostic and predictive stratification but lacks consensus. Recently, the role of microbioma have also been explored regarding its systemic and antitumor immunity. This review gives a comprehensive overview of the aforementioned topics in SCCHN. To this end, the integration of these clinically advantageous biomarkers via construction of an immunogram or nomogram could be an invaluable tool for SCCHN in future prospects.
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Affiliation(s)
- Stijn J. De Keukeleire
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium; (T.V.); (S.R.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
| | - Tijl Vermassen
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium; (T.V.); (S.R.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
| | - Elien Hilgert
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Centre for Medical Genetics Ghent (CMGG), University Hospital Ghent, 9000 Ghent, Belgium
| | - David Creytens
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Department of Pathology, University Hospital Ghent, 9000 Ghent, Belgium
| | - Liesbeth Ferdinande
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Department of Pathology, University Hospital Ghent, 9000 Ghent, Belgium
| | - Sylvie Rottey
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium; (T.V.); (S.R.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
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Liang H, Peng H, Chen L. Prognostic Value of Sarcopenia and Systemic Inflammation Markers in Patients Undergoing Definitive Radiotherapy for Esophageal Cancer. Cancer Manag Res 2021; 13:181-192. [PMID: 33469362 PMCID: PMC7810973 DOI: 10.2147/cmar.s288522] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/18/2020] [Indexed: 01/06/2023] Open
Abstract
Objective To determine the independent and combined prognostic value of sarcopenia and systemic inflammatory markers in esophageal cancer patients undergoing definitive radiotherapy. Methods Sarcopenia was diagnosed on the basis of the skeletal muscle index (SMI) as determined by the skeletal muscle area at the third lumbar (L3) region and body height. The optimal cutoff value of systemic inflammatory markers was determined by the receiver-operating curve (ROC). Logistic regression was used to analyze the correlation among different variables. Cox proportional hazards model was used to identify the factors significantly correlated to overall survival (OS). Based on the results of multivariate survival analysis, a nomogram was established to predict the survival rate. The accuracy of the nomogram was evaluated by the coordination index and the calibration curve. Results A total of 100 esophageal cancer patients were included, of which 77 exhibited sarcopenia. The lymphocyte–monocyte ratio (LMR) was significantly correlated to the risk of sarcopenia (OR = 0.637, 95% CI, 0.452–0.898, P = 0.010). In addition, sarcopenia (P = 0.002, HR = 3.991, 95% CI: 1.653–9.638) and LMR < 2.67 (P < 0.001, HR = 2.665, 95% CI: 1.563–4.543) were independent predictors of OS. Two nomograms with good predictive accuracy were established. Conclusion Sarcopenia and LMR can independently predict the survival of patients with esophageal cancer receiving definitive radiotherapy and have good combined prognostic value.
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Affiliation(s)
- Huanwei Liang
- Department of Radiotherapy, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Huajian Peng
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
| | - Long Chen
- Department of Radiotherapy, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, People's Republic of China
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Ding KQ, Lai ZH, Zhang Y, Yang GY, He JR, Zeng LL. Monocyte-to-Lymphocyte Ratio is Associated with Depression 3 Months After Stroke. Neuropsychiatr Dis Treat 2021; 17:835-845. [PMID: 33776439 PMCID: PMC7989958 DOI: 10.2147/ndt.s299462] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To explore the relationship between the monocyte-to-lymphocyte ratio (MLR) and depression three months after acute ischemic stroke. PATIENTS AND METHODS From May 2013 to September 2014, 203 patients with acute ischemic stroke were recruited within 7 days post-stroke from Shanghai Ruijin Hospital and blood samples were collected after admission. The Hamilton Depression Scale and Clinical Review were evaluated at 3 months after stroke. Based on the Diagnostic and Statistical Manual of Mental Disorders-IV diagnostic criteria, we divided patients into post-stroke depression (PSD) and non-PSD groups. We analyzed the intergroup difference in MLR and the contributing factors. Moreover, dynamic changes in monocytes, lymphocytes and MLR at four different time intervals for all the stroke patients and their relationship with PSD patients were also studied. RESULTS The NIHSS scores and MLR in the PSD group were significantly higher than in the non-PSD group (p<0.05). Logistic regression analysis revealed MLR was an independent risk factor for PSD (odds ratio: 18.020, 95% confidence interval: 1.127‒288.195, p=0.041). MLR correlated negatively with cholesterol and low-density lipoprotein (r=-0.160 and -0.165, respectively, p<0.05). Within 7 days post-acute ischemic stroke, monocytes gradually increased while lymphocytes remained unchanged for all the stroke patients. The MLR value was significantly higher in the PSD group than in the non-PSD group within 24 h post-stroke (p<0.05), but there was no difference in the other three time-intervals between the two groups. CONCLUSION The admission MLR, particularly within 24 h post-stroke, was associated with PSD at 3 months, implying that the MLR might be involved in the PSD inflammatory mechanism.
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Affiliation(s)
- Kai-Qi Ding
- Department of Neurology and Institute of Neurology, Ruijin Hospital/Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ze-Hua Lai
- Department of Neurology and Institute of Neurology, Ruijin Hospital/Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yu Zhang
- Department of Neurology and Institute of Neurology, Ruijin Hospital/Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Guo-Yuan Yang
- Department of Neurology and Institute of Neurology, Ruijin Hospital/Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ji-Rong He
- Department of Neurology and Institute of Neurology, Ruijin Hospital/Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Li-Li Zeng
- Department of Neurology and Institute of Neurology, Ruijin Hospital/Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Zhang Y, Liu Y, Qiu X, Yan B. Concurrent Comparison of the Prognostic Values of Tumor Budding, Tumor Stroma Ratio, Tumor Infiltrating Pattern and Lymphocyte-to-Monocyte Ratio in Colorectal Cancer Patients. Technol Cancer Res Treat 2021; 20:15330338211045826. [PMID: 34658263 PMCID: PMC8521422 DOI: 10.1177/15330338211045826] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objectives: Tumor budding (TB), tumor stroma ratio (TSR), tumor infiltrating pattern (TIP), and preoperative lymphocyte-to-monocyte ratio (LMR) were previously reported to be useful prognostic factors in colorectal cancer (CRC); however, the correlation among these markers and their individual prognostic potency have not been extensively studied. Methods: A cohort of 147 stage I-IV CRC patients was obtained retrospectively, and the patients were divided into subgroups based on low or high TB/TSR/LMR, TIPa (expansile + intermediate) and TIPb (infiltrative) values. The differences in relapse-free survival (RFS) and overall survival (OS) intervals among these subgroups were determined by Kaplan-Meier analysis followed by log-rank tests. The Cox proportional hazard model was applied for the univariate and multivariate analysis of RFS and OS rates. Results:TB, TIP, and LMR, but not TSR, are useful markers for predicting patient survival. Patients with a poor histological grade and large tumor diameter were more likely to present with high TB, TIPb, and low LMR values; in addition, those with advanced T, N, and TNM stages and elevated preoperative CA199 levels had high TB and TIPb levels. TB, TIP, and LMR were significant prognostic factors for the RFS (TB: HR [hazard ratio] = 2.28, 95% CI = 1.30-4.00, P < .01; TIP: HR = 2.60, 95% CI = 1.46-4.60, P < .01; LMR: HR = 0.79, 95% CI = 0.65-0.96, P = .02) and OS (TB: HR = 2.43, 95% CI = 1.32-4.48, P < .01; TIP: HR = 2.49, 95% CI = 1.34-4.63, P < .01; LMR: HR = 0.79, 95% CI = 0.64-0.98, P = .03) intervals. In addition, TB and LMR were independent prognostic factors for the RFS interval (TB: HR = 1.80, 95% CI = 1.01-3.19, P = .05; LMR: HR = 0.80, 95% CI = 0.67-0.96, P = .01), but only LMR was an independent factor for OS rates (HR = 0.80, 95% CI = 0.65-0.98, P = .03). Conclusion: Although TB, TIP, and LMR are useful prognostic markers for CRC, the LMR is likely to be the only independent prognostic factor for both RFS and OS outcomes in practice.
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Affiliation(s)
- Yingcheng Zhang
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Naval Medical University, Shanghai, P.R. China
| | - You Liu
- Department of Pathology, Hainan Hospital of Chinese PLA General Hospital, Sanya, P.R. China
| | - Xiaomei Qiu
- Department of Pathology, Hainan Hospital of Chinese PLA General Hospital, Sanya, P.R. China
| | - Bing Yan
- Department of Oncology, Hainan Hospital of Chinese PLA General Hospital, Sanya, P.R. China
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Tsai MH, Huang TL, Chuang HC, Lin YT, Fang FM, Lu H, Chien CY. Clinical significance of pretreatment prognostic nutritional index and lymphocyte-to-monocyte ratio in patients with advanced p16-negative oropharyngeal cancer-a retrospective study. PeerJ 2020; 8:e10465. [PMID: 33344090 PMCID: PMC7718802 DOI: 10.7717/peerj.10465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/10/2020] [Indexed: 11/20/2022] Open
Abstract
Background Systemic inflammation and nutritional status both play roles in the survival of cancer patients. Therefore, it is important to understand the effects of prognostic nutritional index (PNI) and lymphocyte-to-monocyte ratio (LMR) on the survival of patients with advanced p16-negative oropharyngeal cancer. Methods A total of 142 patients diagnosed with advanced p16-negative oropharyngeal cancer between 2008 and 2015 were enrolled in this study. All patients received primary treatment with definite concurrent chemoradiotherapy (CCRT). Optimal cutoff values for PNI and LMR were determined using receiver operating characteristic curves for survival prediction. Survival rates for different level of PNI and LMR were estimated and compared using Kaplan–Meier method and log-rank test to see if there were significant effects on these end points, including 5-year overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS) rates. The effects of PNI and LMR on survival were assessed using Cox regression model adjusted for other prognostic factors. Results The results showed the optimal cutoff values for PNI and LMR were 50.5 and 4.45, respectively. A high PNI (≧50.5) was significantly improved the 5-year OS. A low LMR (<4.45) was significantly associated with a poor 5-year DFS, DSS, and OS. In multivariate analysis, both PNI and LMR were independent prognosticators for 5-year OS. Conclusions Elevated pretreatment PNI and LMR are both favorable prognosticators in advanced p16-negative oropharyngeal cancer patients undergoing CCRT.
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Affiliation(s)
- Ming-Hsien Tsai
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Pharmacy and Health Care, Tajen University, Pingtung County, Taiwan
| | - Tai-Lin Huang
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui-Ching Chuang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu-Tsai Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Pharmacy and Health Care, Tajen University, Pingtung County, Taiwan
| | - Fu-Min Fang
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui Lu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Institute For Translational Research In Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Chuang HC, Tsai MH, Lin YT, Chou MH, Huang TL, Chiu TJ, Lu H, Fang FM, Chien CY. The Clinical Impacts of Pretreatment Peripheral Blood Ratio on Lymphocytes, Monocytes, and Neutrophils Among Patients with Laryngeal/Hypopharyngeal Cancer Treated by Chemoradiation/Radiation. Cancer Manag Res 2020; 12:9013-9021. [PMID: 33061596 PMCID: PMC7524172 DOI: 10.2147/cmar.s275635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to investigate the clinical impacts of the pretreatment peripheral blood ratios of lymphocytes, monocytes and neutrophils among patients with hypopharyngeal cancer/laryngeal cancer. Patients and Methods A total of 141 people with cases of hypopharyngeal cancer/laryngeal cancer were enrolled to evaluate the clinical impacts of the systemic inflammation response index (SIRI), neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) in pretreatment blood among patients with laryngeal/hypopharyngeal cancer between January 2012 and December 2014. Results Those patients with higher pretreatment LMR (>2.99) showed a significantly higher 5-year complete response rate (CR) (69% vs 31%) than those with lower LMR (≤2.99, p = 0.006). Additionally, those patients with lower pretreatment SIRI (<3.26) showed a significantly higher 5-year CR (90% vs 10%) than those with higher SIRI (≥3.26, p < 0.001). Patients with higher LMR had better 5-year overall survival (OS) (p = 0.01) and 5-year progression-free (PFS) (p = 0.005) rates than those with lower LMR in univariate analysis. Patients with lower SIRI had better 5-year OS (p < 0.001) and 5-year PFS (p < 0.001) than those with higher SIRI in univariate analysis. In the Cox regression analysis, SIRI (HR = 1.941, [95% CI: 1.223-3.081], p = 0.005) and N classification (HR = 2.203, [95% CI: 1.327-3.657], p = 0.002) were independent variables of 5-year OS. In addition, SIRI (HR= 2.127, [95% CI: 1.214-3.725], p = 0.008), T classification (HR = 2.18, [95% CI: 1.072-4.433], p = 0.031), and N classification (HR = 2.329, [95% CI: 1.395-3.889], p = 0.001) were independent variables of 5-year PFS. Conclusion Pretreatment SIRI is superior to LMR in predicting treatment response and clinical outcomes among patients with laryngeal/hypopharyngeal cancer treated by CRT/RTO. SIRI may be adopted in the treatment of laryngeal/hypopharyngeal cancer by CRT/RTO.
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Affiliation(s)
- Hui-Ching Chuang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Hsien Tsai
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu-Tsai Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Huei Chou
- The Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Center for General Education, Cheng-Shiu University, Kaohsiung, Taiwan
| | - Tai-Lin Huang
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tai-Jan Chiu
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui Lu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Lin CH, Chou WC, Wu YY, Lin CY, Chang KP, Liao CT, Ho TY, Yeh CM, Liu CJ, Hung SP, Lee CH, Chen PJ, Chou YC, Fan KH, Huang BS, Tung-Chieh Chang J, Wang CC, Tsang NM. Prognostic significance of dynamic changes in lymphocyte-to-monocyte ratio in patients with head and neck cancer treated with radiotherapy: results from a large cohort study. Radiother Oncol 2020; 154:76-86. [PMID: 32941957 DOI: 10.1016/j.radonc.2020.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/23/2020] [Accepted: 09/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE We sought to investigate whether dynamic changes in lymphocyte-to-monocyte ratio (LMR) occurring during the course of radiotherapy (RT) may have prognostic value in patients with head and neck cancer (HNC). MATERIALS AND METHODS We retrospectively reviewed the clinical records of patients with HNC who underwent RT at our center between 2005 and 2013. Generalized estimating equations were used to longitudinally assess changes in LMR through the course of RT. Delta-LMR was calculated as the difference between LMR measured during treatment and baseline LMR values. Freedom from metastasis (FFM) and overall survival (OS) served as the main outcome measures. RESULTS A total of 1431 patients with HNC were enrolled. After a median follow-up of 9 years, 636 (44.4%) patients died and 240 (16.8%) had distant metastases. Compared with patients with low delta-LMR at two weeks, those with high delta-LMR experienced less favorable outcomes (five-year OS: 73% versus 59%, respectively, p < 0.001; five-year FFM: 87% versus 80%, respectively, p = 0.015). Similar findings were observed for delta-LMR measured at four weeks (five-year OS: 72% versus 60%, p < 0.001; five-year FFM: 86% versus 79%, respectively, p = 0.002) and six weeks (five-year OS: 72% versus 57%, p < 0.001; five-year FFM: 87% versus 79%, respectively, p = 0.002). Multivariate analysis identified delta-LMR as an independent prognostic factor for both FFM and OS. CONCLUSION Delta-LMR is a simple and inexpensive biomarker that may be clinically useful for predicting FFM and OS in patients with HNC treated with RT.
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Affiliation(s)
- Chia-Hsin Lin
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Wen-Chi Chou
- Department of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, College of Medicine, Taoyaun, Taiwan.
| | - Yao-Yu Wu
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Chien-Yu Lin
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Kai-Ping Chang
- Department of Otolaryngology-Head Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University at Lin-Kou, Taoyuan, Taiwan.
| | - Chun-Ta Liao
- Department of Otolaryngology-Head Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University at Lin-Kou, Taoyuan, Taiwan.
| | - Tsung-Ying Ho
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
| | - Chiu-Mei Yeh
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
| | - Chia-Jen Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
| | - Sheng-Ping Hung
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Ching-Hsin Lee
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Po-Jui Chen
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Yung-Chih Chou
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Kang-Hsing Fan
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Bing-Shen Huang
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan.
| | - Joseph Tung-Chieh Chang
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan; Department of Radiation Oncology, Xiamen Chang Gung Memorial Hospital, Fujian, China.
| | - Chun-Chieh Wang
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan.
| | - Ngan-Ming Tsang
- Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan City, Taiwan; School of Traditional Chinese Medicine, Chang Gung University, Taoyuan City, Taiwan; Department of Radiation Oncology, Fangliao General Hospital, PingTung Hsien, Taiwan.
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Hasegawa T, Iga T, Takeda D, Amano R, Saito I, Kakei Y, Kusumoto J, Kimoto A, Sakakibara A, Akashi M. Neutrophil-lymphocyte ratio associated with poor prognosis in oral cancer: a retrospective study. BMC Cancer 2020; 20:568. [PMID: 32552873 PMCID: PMC7302163 DOI: 10.1186/s12885-020-07063-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023] Open
Abstract
Background Prognostic biomarkers provide essential information about a patient’s overall outcome. However, existing biomarkers are limited in terms of either sample collection, such as requiring tissue specimens, or the process, such as prolonged time for analysis. In view of the need for convenient and non-invasive prognostic biomarkers for oral cancer, we aimed to investigate the prognostic values of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio in patient survival. We also aimed to explore the associations of these ratios with the clinicopathologic characteristics of Japanese oral squamous cell carcinoma patients. Methods This study was a non-randomized retrospective cohort study in a tertiary referral center. We included 433 patients (246 men, 187 women) who underwent radical surgery for oral cancers between January 2001 and December 2013. We evaluated various risk factors for poor prognosis including neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio with univariate and multivariate analyses. The disease-specific survival and overall survival rates of patients were compared among the factors and biomarkers. Results In multivariable Cox proportional hazards analysis, high neutrophil-to-lymphocyte ratio (hazard ratio 2.87, 95% confidence interval 1.59–5.19, P < 0.001), moderately or poorly differentiated histology (hazard ratio 2.37, 95% confidence interval 1.32–4.25, P < 0.001), and extranodal extension (hazard ratio 1.95, 95% confidence interval 1.13–3.35, P = 0.016) were independent predictors of disease-specific survival. High neutrophil-to-lymphocyte ratio (hazard ratio 2.30, 95% confidence interval 1.42–3.72, P < 0.001), moderately or poorly differentiated (hazard ratio 1.72, 95% confidence interval 1.07–2.76, P = 0.025), and extranodal extension (hazard ratio 1.79, 95% confidence interval 1.13–2.84, P = 0.013) were independent predictors of overall survival. Conclusions Neutrophil-to-lymphocyte ratio might be a potential independent prognostic factor in Japanese oral squamous cell carcinoma patients.
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Affiliation(s)
- Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Tomoya Iga
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Daisuke Takeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Rika Amano
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Izumi Saito
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Junya Kusumoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akira Kimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akiko Sakakibara
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Zhao K, Wang C, Shi F, Li M, Yu J. Lymphocyte-monocyte ratio as a predictive marker for pathological complete response to neoadjuvant therapy in esophageal squamous cell carcinoma. Transl Cancer Res 2020; 9:3842-3853. [PMID: 35117751 PMCID: PMC8797548 DOI: 10.21037/tcr-19-2849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/14/2020] [Indexed: 12/24/2022]
Abstract
Background The hematological markers of systemic inflammation has been proved to be significantly associated with clinical outcomes in esophageal cancer. This retrospectively study was to evaluate the value of the hematological markers in predicting pathological complete response (pCR) and overall survival (OS) in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) who received neoadjuvant chemoradiotherapy (nCRT). Methods A total of 87 patients with newly diagnosed LA-ESCC were retrospectively analyzed. The pretreatment lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were selected as hematological markers. Results After nCRT, 26 (29.9%) patients achieved pCR and 61 (70.1%) patients had non-pCR. The LMR was significantly higher in patients who achieved pCR compared to that in patients who did not achieve pCR (4.35±1.68 vs. 3.33±1.13, P=0.002). Based on the receiver operating characteristic (ROC) curve, the optimal cut off value of LMR that predicted pCR was 3.73 [area under the curve: 0.712; 95% confidence interval (CI): 0.594–0.830; P=0.002], with a sensitivity of 65.4% and specificity of 77.0%. The pCR rate of patients with LMR ≥3.73 was 53.1%, while the pCR rate of patients with LMR <3.73 was only 16.4% (P<0.001). The univariate and multivariate logistic regression analysis confirmed that LMR was an independent predictor of pCR [odds ratio: 5.093; 95% CI: 1.658–15.646; P=0.004]. However, in the prediction of OS, a multivariate Cox proportional hazard model revealed that only clinical stage [hazard ratio (HR): 1.970; 95% CI: 1.144–3.391; P=0.014] and pCR (HR: 0.469; 95% CI: 0.237–0.928; P=0.030) were independent prognostic factors. Conclusions Pre-treatment LMR may predict pCR in LA-ESCC patients who were treated with nCRT. Having pCR is an independent prognostic factor for prolonged survival.
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Affiliation(s)
- Kewei Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China.,Department of Radiation Oncology, Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College, Yantai, China
| | - Chunsheng Wang
- Department of Radiation Oncology, Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College, Yantai, China
| | - Fang Shi
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
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Zhou S, Yuan H, Wang J, Hu X, Liu F, Zhang Y, Jiang B, Zhang W. Prognostic value of systemic inflammatory marker in patients with head and neck squamous cell carcinoma undergoing surgical resection. Future Oncol 2020; 16:559-571. [PMID: 32166977 DOI: 10.2217/fon-2020-0010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: To explore the prognostic value of the systemic inflammatory marker (SIM) based on neutrophil, lymphocyte and monocyte counts in head and neck squamous cell carcinoma (HNSCC) patients. Patients & methods: We retrospectively collected the data of 367 patients with HNSCC who underwent surgery. The Kaplan-Meier survival analysis and Cox regression analysis were conducted on disease-free survival and overall survival. Results: A high SIM (>1.34) was associated with larger tumor size, advanced clinical stage and shorter survival time. The survival analysis showed that only clinical stage and SIM were independent prognostic indicators of disease-free survival and overall survival. Conclusion: The SIM positively correlated with tumor progression and might be a powerful prognostic indicator of poor outcome in patients with HNSCC.
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Affiliation(s)
- Shichao Zhou
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Haihua Yuan
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Jiongyi Wang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Xiaohua Hu
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Feng Liu
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Yanjie Zhang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Bin Jiang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Wenying Zhang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
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Zhang J, Feng W, Ye Z, Wei Y, Li L, Yang Y. Prognostic significance of platelet-to-lymphocyte ratio in patients with nasopharyngeal carcinoma: a meta-analysis. Future Oncol 2019; 16:117-127. [PMID: 31789058 DOI: 10.2217/fon-2019-0520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: Several studies reported the association of platelet-to-lymphocyte ratio (PLR) and prognosis in nasopharyngeal carcinoma (NPC), but the results remain controversial. Therefore, we investigated the prognostic value of PLR in NPC through meta-analysis. Materials & methods: A comprehensive literature search of PubMed, Embase and Web of Science was performed. Results: A total of 9 studies comprising of 3459 patients with NPC were included. The data demonstrated that an increased PLR predicted poor overall survival, progression-free survival and distant metastasis-free survival. There was no significant association between PLR and sex, age, T stage, N stage, tumor node metastasis (TNM) stage or intensity-modulated radiotherapy. Conclusion: This meta-analysis revealed that PLR might be a potential predicative biomarker of poor prognosis in patients with NPC.
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Affiliation(s)
- Junkai Zhang
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Weineng Feng
- Department of Head & Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, PR China
| | - Zhihua Ye
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Ying Wei
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Lamei Li
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Yingyu Yang
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
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Valero C, Pardo L, Sansa A, Garcia Lorenzo J, López M, Quer M, León X. Prognostic capacity of Systemic Inflammation Response Index (SIRI) in patients with head and neck squamous cell carcinoma. Head Neck 2019; 42:336-343. [PMID: 31750591 DOI: 10.1002/hed.26010] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 10/27/2019] [Accepted: 10/30/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Inflammation and immune evasion are associated with carcinogenesis. Systemic Inflammation Response Index (SIRI) has been proposed as a pretreatment peripheral blood biomarker. The aim of this study is to analyze its prognostic capacity in head and neck squamous cell carcinomas (HNSCC). METHODS We performed a retrospective study in 824 patients with HNSCC. SIRI was calculated by neutrophils*monocytes/lymphocytes. Using a recursive-partitioning analysis considering disease-specific survival (DSS) as dependent variable, three categories were defined according to SIRI value. RESULTS Males, patients with history of toxic consumption, oropharyngeal or hypopharyngeal tumors, and advanced tumors had a significantly higher SIRI value. As SIRI increased, a significant decrease in DSS was observed. In a multivariable analysis, SIRI was an independent predictor of DSS. Moreover, SIRI was a significant predictor of local, regional, and distant recurrence-free survival. CONCLUSIONS SIRI has independent prognostic capacity in HNSCC. Patients with higher SIRI have a significant decrease in DSS.
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Affiliation(s)
- Cristina Valero
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Pardo
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Aina Sansa
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jacinto Garcia Lorenzo
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Montserrat López
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Quer
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier León
- Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
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Systemic immune response in squamous cell carcinoma of the head and neck: a comparative concordance index analysis. Eur Arch Otorhinolaryngol 2019; 276:2913-2922. [DOI: 10.1007/s00405-019-05554-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/09/2019] [Indexed: 02/07/2023]
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Wichmann G, Gaede C, Melzer S, Bocsi J, Henger S, Engel C, Wirkner K, Wenning JR, Wald T, Freitag J, Willner M, Kolb M, Wiegand S, Löffler M, Dietz A, Tárnok A. Discrimination of Head and Neck Squamous Cell Carcinoma Patients and Healthy Adults by 10-Color Flow Cytometry: Development of a Score Based on Leukocyte Subsets. Cancers (Basel) 2019; 11:cancers11060814. [PMID: 31212819 PMCID: PMC6628584 DOI: 10.3390/cancers11060814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/29/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Leukocytes in peripheral blood (PB) are prognostic biomarkers in head and neck squamous cell carcinoma cancer patients (HNSCC-CPs), but differences between HNSCC-CPs and healthy adults (HAs) are insufficiently described. Methods: 10-color flow cytometry (FCM) was used for in-depth immunophenotyping of PB samples of 963 HAs and 101 therapy-naïve HNSCC-CPs. Absolute (AbsCC) and relative cell counts (RelCC) of leukocyte subsets were determined. A training cohort (TC) of 43 HNSCC-CPs and 43 HAs, propensity score (PS)-matched according to age, sex, alcohol, and smoking, was used to develop a score consecutively approved in a validation cohort (VC). Results: Differences in AbsCC were detected in leukocyte subsets (p < 0.001), but had low power in discriminating HNSCC-CPs and HAs. Consequently, RelCC of nine leukocyte subsets in the TC were used to calculate 36 ratios; receiver operating characteristic (ROC) curves defined optimum cut-off values. Binary classified data were combined in a score based on four ratios: monocytes-to-granulocytes (MGR), classical monocytes-to-monocytes (clMMR), monocytes-to-lymphocytes (MLR), and monocytes-to-T-lymphocytes (MTLR); ≥3 points accurately discriminate HNSCC-CPs and HAs in the PS-matched TC (p = 2.97 × 10−17), the VC (p = 4.404 × 10−178), and both combined (p = 7.74 × 10−199). Conclusions: RelCC of leukocyte subsets in PB of HNSCC-CPs differ significantly from those of HAs. A score based on MGR, clMMR, MLR, and MTLR allows for accurate discrimination.
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Affiliation(s)
- Gunnar Wichmann
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
| | - Clara Gaede
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Susanne Melzer
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
- Clinical Trial Centre Leipzig, University Leipzig, Härtelstr. 16-18, 04107 Leipzig, Germany.
| | - Jozsef Bocsi
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
| | - Sylvia Henger
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Härtelstr. 10-18, 04107 Leipzig, Germany.
| | - Christoph Engel
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Härtelstr. 10-18, 04107 Leipzig, Germany.
| | - Kerstin Wirkner
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
| | - John Ross Wenning
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Theresa Wald
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Josefine Freitag
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Maria Willner
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Marlen Kolb
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Susanne Wiegand
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
| | - Markus Löffler
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Härtelstr. 10-18, 04107 Leipzig, Germany.
| | - Andreas Dietz
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany.
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
| | - Attila Tárnok
- LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany.
- Department of Precision Instruments, Tsinghua University, Beijing 100084, China.
- Fraunhofer Institute for Cell Therapy and Immunology IZI, Perlickstr. 1, 04103 Leipzig, Germany.
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Song Q, Wu JZ, Wang S. Low Preoperative Lymphocyte to Monocyte Ratio Serves as a Worse Prognostic Marker in Patients with Esophageal Squamous Cell Carcinoma Undergoing Curative Tumor Resection. J Cancer 2019; 10:2057-2062. [PMID: 31205566 PMCID: PMC6548163 DOI: 10.7150/jca.29383] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/03/2019] [Indexed: 12/24/2022] Open
Abstract
Preoperative lymphocyte to monocyte ratio (LMR) has been considered a prognostic factor in various cancers. However, the application of LMR in the assessment of patients with esophageal squamous cell carcinoma (ESCC) remains controversial. This study aimed to investigate whether preoperative LMR could serve as a prognostic marker in patients with ESCC undergoing curative tumor resection. Medical records of 680 patients of ESCC after curative surgery without preoperative adjuvant therapy were obtained. The median of LMR was determined as the optimal cut off value. The association of LMR with clinical features of ESCC was analyzed using chi-square tests. Spearman's correlation coefficient was used to calculate the correlation. Disease-free survival (DFS) and overall survival (OS) stratified by LMR were evaluated using Kaplan-Meier method and log-rank test. The LMR was negatively correlated with sex (r=-0.245, P<0.001). Low LMR (LMR<3.17) predicted a shorter DFS and OS in patients with ESCC. Multivariate analyses revealed that LMR was independently correlated with DFS (hazard ratios 0.854; 95% confidence interval 0.768-0.949; P=0.003) and OS (hazard ratios 0.864; 95% confidence interval 0.779-0.958; P=0.006). Our study indicated that low LMR could serve as an independent worse prognostic marker in patients with ESCC.
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Affiliation(s)
- Qian Song
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Jun-Zhou Wu
- Cancer Research Institute, Zhejiang Cancer Hospital & Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Sheng Wang
- Department of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, People's Republic of China
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Gao XP, Liu YH, Liu ZY, Wang LJ, Jing CX, Zhu S, Zeng FF. Pretreatment lymphocyte-to-monocyte ratio as a predictor of survival among patients with ovarian cancer: a meta-analysis. Cancer Manag Res 2019; 11:1907-1920. [PMID: 30881117 PMCID: PMC6398401 DOI: 10.2147/cmar.s184970] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction In this meta-analysis, we analyzed retrospective cohort studies that assessed the prognostic potential of the pretreatment lymphocyte-to-monocyte ratio (LMR) among patients with ovarian cancer (OC). Materials and methods We comprehensively searched electronic databases, including PubMed and Embase, from inception through October 2018. A random-effects model was used to calculate pooled HRs and their 95% CIs for overall survival (OS) and progression-free survival (PFS). The low LMR group was treated as the reference group. Results Twelve studies, including 3,346 OC cases at baseline, were included. Overall, our results indicated that LMR was positively associated with both OS (HR: 1.85, 95% CI: 1.50–2.28, P<0.001; I2=76.5%) and PFS (HR: 1.70, 95% CI: 1.49–1.94, P<0.001; I2=24.4%) among OC patients. Stratified analyses indicated that, for OS, the LMR’s protective effect was more evident in studies conducted among younger patients (<55 years) than in those conducted among older patients (≥55 years; P for interaction =0.017), which was confirmed by meta-regression analysis (P=0.004). Conclusion This study suggested that a higher pretreatment LMR level was associated with a favorable prognosis among OC patients. Future large-scale prospective clinical trials are needed to confirm the prognostic value of LMR among OC patients.
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Affiliation(s)
- Xu-Ping Gao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China,
| | - Yan-Hua Liu
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Ze-Ying Liu
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China,
| | - Li-Jun Wang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China
| | - Chun-Xia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China,
| | - Sui Zhu
- Department of Medical Statistics, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China,
| | - Fang-Fang Zeng
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China,
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Tham T, Leung E, Olson C, Wotman M, Khaymovich J, Coury J, Teegala S, Costantino P. Evaluation of the prognostic utility of the combination of platelet count with mean platelet volume as a prognostic indicator in head and neck cancer. Mol Clin Oncol 2019; 10:457-462. [PMID: 30931118 DOI: 10.3892/mco.2019.1813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 01/24/2019] [Indexed: 12/11/2022] Open
Abstract
The combination of platelet count to mean platelet volume (COP-MPV) has been recently reported as a prognostic indicator of oral cavity cancer and other cancer sites. The aim of the present study was to validate the utility of the COP-MPV as a prognostic indicator in all head and neck cancer (HNC) sites. The clinicopathological characteristics of the COP-MPV with HNC were also investigated. This is a retrospective cohort study that recruited consecutively treated patients at a tertiary level academic hospital. Clinicopathological characteristics were recorded, including the COP-MPV scores. Survival was analyzed using Kaplan-Meier analysis, as well as multivariate Cox Proportional Hazards regression. COP-MPV was not associated with the survival outcome in univariate or multivariate analysis. In the multivariate model, tumor differentiation, tumor stage, nodal stage, surgical margins and hemoglobin were revealed to be significantly associated with survival. The results demonstrated that the COP-MPV is not a suitable prognostic factor for HNC.
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Affiliation(s)
- Tristan Tham
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Edric Leung
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Caitlin Olson
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Michael Wotman
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Julian Khaymovich
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Josephine Coury
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Sireesha Teegala
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
| | - Peter Costantino
- Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York Head & Neck Institute, New York, NY 10075, USA
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Tham T, Olson C, Wotman M, Teegala S, Khaymovich J, Coury J, Costantino P. Evaluation of the prognostic utility of the hemoglobin-to-red cell distribution width ratio in head and neck cancer. Eur Arch Otorhinolaryngol 2018; 275:2869-2878. [PMID: 30251123 DOI: 10.1007/s00405-018-5144-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/20/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Hemoglobin is a known prognostic marker in many cancers, including head and neck cancer (HNC). There is some evidence that the red cell distribution width, which is an index of variation in size of red blood cells (RBCs), might be associated with prognosis as well. Recently, a novel prognostic biomarker has been reported-the ratio of the hemoglobin-to-red cell distribution width (Hb/RDW). Our objective was to evaluate the prognostic utility of the pretreatment Hb/RDW in HNC, controlled with known prognostic indices. METHODS Retrospective cohort study in a tertiary academic hospital setting. Patients diagnosed with HNC treated with curative-intent surgery were eligible. Metastatic disease was excluded. The variables collected were age, sex, BMI, alcohol/tobacco exposure, performance scores, ACE-27, tumor characteristics, adjuvant treatment, and lab values. The primary endpoints were event-free survival (EFS) and overall survival (OS). OS was defined as time from start of treatment to death from any cause, and EFS was defined as time from start of treatment to any progression, recurrence, or death from any cause. Univariate and multivariate survival analysis was performed on the primary endpoints. RESULTS A total of 205 patients were enrolled from 2010 to 2016. In multivariate analysis, the factors independently associated with EFS were BMI (p = 0.0364), advanced T stage (p = 0.001), and low Hb/RDW ratio (p = 0.017). The factors independently associated with OS were ECOG score (p = 0.042), advanced T stage (p < 0.0001), positive nodes (p = 0.0195), and Hemoglobin (0.0134). CONCLUSION A low Hb/RDW ratio was associated with poorer EFS (HR = 2.02, 95% CI 1.13-3.61, p = 0.017), but was not associated with OS. This is the first study reporting the prognostic utility of Hb:RDW in head and neck cancer.
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Affiliation(s)
- Tristan Tham
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA.
| | - Caitlin Olson
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA
| | - Michael Wotman
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA
| | - Sireesha Teegala
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA
| | - Julian Khaymovich
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA
| | - Josephine Coury
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA
| | - Peter Costantino
- Department of Otolaryngology, Head and Neck Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 130 East 77th Street, 10th Floor, New York, NY, 10075, USA
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