Clinical significance of pretreatment prognostic nutritional index and lymphocyte-to-monocyte ratio in patients with advanced p16-negative oropharyngeal cancer-a retrospective study

Ming-Hsien Tsai; Tai-Lin Huang; Hui-Ching Chuang; Yu-Tsai Lin; Fu-Min Fang; Hui Lu; Chih-Yen Chien

doi:10.7717/peerj.10465

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 Dec 1:8:e10465. doi: 10.7717/peerj.10465. eCollection 2020.

Authors

Ming-Hsien Tsai^{1

2

3}, Tai-Lin Huang^{2

4}, Hui-Ching Chuang^{1

2}, Yu-Tsai Lin^{1

2

3}, Fu-Min Fang^{2

5}, Hui Lu¹, Chih-Yen Chien^{1

2

6}

Affiliations

¹ Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
² Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
³ College of Pharmacy and Health Care, Tajen University, Pingtung County, Taiwan.
⁴ Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
⁵ Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
⁶ Institute For Translational Research In Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

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.

Keywords: Chemoradiation; Lymphocyte-to-monocyte ratio; Oropharyngeal cancer; Prognostic nutritional index; Survival.

Grants and funding

This work was supported by grants nos. CMRPG 8D1421 and CORPG8F1481-3 from Kaohsiung Chang Gung Memorial Hospital. There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.