Preoperative Neutrophil-to-Lymphocyte Ratio as Prognostic Predictor for Hypopharyngeal Squamous Cell Carcinoma after Radical Resections

Objectives: Hypopharyngeal squamous cell carcinoma (HPSCC) is an aggressive disease in the head and neck region. Therefore, simple and useful prognostic predictors of HPSCC are needed for clinical practice. This study investigates the prognostic significance of pre-operative neutrophil-to-lymphocyte ratio (NLR) in patients with HPSCC who received radical resections. Methods: Retrospective review was conducted on medical records at a tertiary referral hospital involving 146 consecutive patients who underwent radical resection for HPSCC between January 2000 and December 2010. The prognostic significance of NLR and other clinicopathologic factors was analyzed. The relationships between the NLR value and clinicopathologic factors were also evaluated. Results: The study cohort consisted of 146 patients with HPSCC, with a mean age of 57.5 years (range, 34-89 years). The median number of NLR was 2.28 (range, 0.71-8.75). On the basis of this median value, the cutoff value of NLR was set as 2.3. The patients were divided into 2 groups: a low (<2.3) NLR group and a high (>= 2.3) NLR group. Patients with NLR of 2.3 or more had significantly higher incidence of wound complications (P = 0.026). The 3-year overall survival rate was 69.9% in patients in the low NLR group and 27.4% in those in the high NLR group (P <0.001; hazard ratio; 2.99; 95% confidence interval, 1.91-4.67). Conclusions: Results showed that high preoperative NLR is associated with increased wound complications and poor survival in patients with HPSCC.