The association of anemia and high neutrophil-lymphocyte ratio with decreased survival in patients with laryngeal cancer treated with radiotherapy

Authors : Ela DELİKGÖZ SOYKUT, Yasemin KEMAL, Serkan KAPLAN, Cengiz KARAÇİN, Eylem ODABAŞI, Asude UNAL, Zehra ER, Suheyla AYTAÇ ARSLAN, Yıldız GUNEY

Pages : 227-236

Doi:10.38053/acmj.1290362

View : 69 | Download : 58

Publication Date : 2023-07-28

Article Type : Research Paper

Abstract :Aims: We aimed to examine the prognostic value of inflammatory markers such as neutrophil‐to‐lymphocyte ratio insert ignore into journalissuearticles values(NLR);, platelet‐to‐lymphocyte ratio insert ignore into journalissuearticles values(PLR);, systemic immune-inflammation index insert ignore into journalissuearticles values(SII);, and anemia on oncological outcomes in patients with laryngeal squamous cell carcinomas insert ignore into journalissuearticles values(LSCC); treated with radiotherapy. Methods: 213 LSCC patients analyzed retrospectively. Inflammatory markers were established by examining blood samples taken within 7 days before treatment. Patients were categorized into two groups: low and high according to NLR, PLR, and SII threshold values. In addition, to evaluate the effect of hemoglobin insert ignore into journalissuearticles values(Hb); level, the threshold value of each inflammatory marker and Hb level were combined, and 3 groups were formed insert ignore into journalissuearticles values(3 groups for NLR, 3 groups for PLR, and 3 groups for SII);. The relationship between inflammatory markers and overall survival insert ignore into journalissuearticles values(OS);, disease-free survival insert ignore into journalissuearticles values(DFS);, and local regional recurrence-free survival insert ignore into journalissuearticles values(LRRFS); was investigated. Results: In univariate analysis, high NLR, PLR, SII, and low Hb insert ignore into journalissuearticles values(<13 g/dl); level were associated with worse survival insert ignore into journalissuearticles values(all p<0.022);, except for PLR and Hb for LRRFS. OS and DFS were significantly better in patients in each group A with a low inflammatory index and high Hb insert ignore into journalissuearticles values(all p<0.013);. In the multivariate analysis, high NLR and group CNLR insert ignore into journalissuearticles values(high NLR with low Hb); were statistically significant predictors of decreased OS insert ignore into journalissuearticles values(HR 1.85, 95% CI 1.05-3.28, p=0.033; HR 2.61, 95% CI 1.14-5.97, p=0.022); and DFS insert ignore into journalissuearticles values(HR 1.81, 95% CI 1.11-2.96, p=0.017; HR 3.32, 95% CI 1.20-9.16, p=0.028);. Conclusion: NLR may serve as a potential prognostic biomarker in LSCC, and its predictive ability is further enhanced when NLR is combined with Hb level.
Keywords : Anemia, laryngeal squamous cell carcinoma, neutrophil to lymphocyte ratio, platelet‐to‐lymphocyte ratio, radiotherapy, systemic immune inflammation index