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The prognostic value of systemic and local inflammation in patients with laryngeal squamous cell carcinoma

Authors Wang J, Wang SZ, Song XM, Zeng WJ, Wang SY, Chen F, Ding H

Received 21 May 2016

Accepted for publication 18 September 2016

Published 21 November 2016 Volume 2016:9 Pages 7177—7185


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 4

Editor who approved publication: Professor Jianmin Xu

Jie Wang,1,* Shengzi Wang,1 Xinmao Song,1,* Wenjiao Zeng,2 Shuyi Wang,3 Fu Chen,1 Hao Ding1

1Department of Radiation Oncology, Eye, Ear, Nose, and Throat Hospital, Fudan University, 2Department of Pathology, Shanghai Medical School, Fudan University, 3Department of Pathology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Background: Cancer-related systemic inflammation has been demonstrated to be associated with poor outcome in multiple types of cancers. Meanwhile, the local inflammation, which is characterized by dense intratumoral immune infiltrate, is a favorable predictor of survival outcome.
Purpose: To evaluate the role of systemic and local inflammation in predicting outcome in patients with laryngeal squamous cell carcinoma.
Patients and methods: In this retrospective study, 120 patients who had undergone postoperative radiotherapy were enrolled. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as calculated from pretreatment whole blood counts, were used to indicate systemic inflammation. The optimal cutoff values of NLR and PLR were determined using receiver operating characteristic curve analysis. Tumor infiltrating lymphocytes (TILs) density, as assessed by pathologist review of hematoxylin and eosin-stained slides, was used to represent local inflammation. Overall survival (OS) and recurrence-free survival (RFS) were assessed using the Kaplan–Meier method and multivariate Cox regression analysis.
Results: The best cutoff was 2.79 for NLR and 112 for PLR. Kaplan–Meier analysis revealed that high NLR, high PLR, and low TILs density were significantly correlated with inferior OS and RFS, respectively (all P<0.05). The Cox proportional multivariate hazard model showed that a high pretreatment PLR and a low TILs density were both independently correlated with poor OS and RFS, respectively (all P<0.05).
Conclusion: Markers of systemic and local inflammation, especially PLR and TILs density, are reliable prognostic factors in patients with laryngeal squamous cell carcinoma.

Keywords: laryngeal squamous cell carcinoma, systemic inflammation, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, tumor inflltrating lymphocytes

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