Assessment of Pretreatment Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Prognosis of Oral Squamous Cell Carcinoma

Purpose: Recent data have provided evidence of systemic inflammatory markers playing an important role in determining the disease-free survival (DFS) and overall survival (OS) of patients with oral squamous cell carcinoma (OSCC). The aim of the present study was to determine the prognosis of OSCC using the preoperative neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). Patients and Methods: We enrolled 130 patients with OSCC who received treatment in the present retrospective study. Both PLR and NLR correlated with the demographic data, tumor characteristics, and prognosis. The optimal cutoff for PLR and NLR was determined by receiver operating characteristic curve analysis and was 142 and 3.1 for PLR and NLR, respectively. The prognostic significance of both markers was determined by univariate and multivariate analysis. Survival curves were plotted using the Kaplan-Meier method. Results: The clinicopathologic variables correlated with cumulative survival on univariate analysis. Advanced clinical lymph node stage ( P = .001), pathologic lymph node stage ( P = .001), pathologic tumor stage ( P = .049), pathologic TNM stage ( P = .006), receipt of multimodality treatment ( P = .013), and high PLRs ( P = .001) and NLRs ( P = .002) showed a statistically significant association with shorter DFS. A multivariate Cox proportional hazard regression model demonstrated that a high PLR (hazard ratio [HR], 2.998; 95% confidence interval [CI], 1.128 to 7.968; P = .028) and patient age (HR, 1.100; 95% CI, 0.750 to 1.613; P = .025) were independent factors for determining DFS and OS. Conclusions: We observed that high PLRs and NLRs were significant in determining the prognosis. The PLR was superior to the NLR in determining DFS and OS and can be used as an independent prognostic indicator in patients with OSCC. (C) 2020 American Association of Oral and Maxillofacial Surgeons