Prognostic significance of neutrophil-to-lymphocyte ratio in HPV status era for oropharyngeal cancer
Giuseppe Fanetti
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Giuseppe Fanetti and Daniela Alterio are co-first authors.Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorDaniela Alterio
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Giuseppe Fanetti and Daniela Alterio are co-first authors.Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorCorresponding Author
Giulia Marvaso
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Correspondence
Giulia Marvaso, Department of Radiation Oncology, IEO, Istituto Europeo di Oncologia IRCCS, Via Ripamonti, 435, Milano 20141, Italy.
Email: [email protected]
Contribution: Conceptualization, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorSara Gandini
Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Formal analysis, Supervision, Validation
Search for more papers by this authorDamaris Patricia Rojas
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Conceptualization, Visualization, Writing - review & editing
Search for more papers by this authorCarlo Gobitti
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Formal analysis, Writing - review & editing
Search for more papers by this authorEmilio Minatel
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Conceptualization, Writing - review & editing
Search for more papers by this authorAlberto Revelant
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Conceptualization, Data curation, Writing - review & editing
Search for more papers by this authorAngela Caroli
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Conceptualization, Data curation, Validation, Writing - review & editing
Search for more papers by this authorClaudia Maria Francia
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Claudia Maria Francia: Affiliation at the time of the study.Contribution: Data curation, Validation, Writing - review & editing
Search for more papers by this authorOmbretta Alessandro
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
Contribution: Conceptualization, Writing - review & editing
Search for more papers by this authorMatteo Pepa
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Conceptualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorSimone Giovanni Gugliandolo
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Conceptualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAnna Starzyńska
Department of Oral Surgery, Medical University of Gdańsk, Gdańsk, Poland
Contribution: Writing - review & editing
Search for more papers by this authorJerry Polesel
Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorEmanuela Vaccher
Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorMaria Cossu Rocca
Division of Uro-genital and Head and Neck Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorMarta Tagliabue
Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Formal analysis, Validation, Writing - review & editing
Search for more papers by this authorMohssen Ansarin
Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Investigation, Writing - review & editing
Search for more papers by this authorValentina Lupato
Division of Otolaryngology, Santa Maria degli Angeli General Hospital, Pordenone, Italy
Contribution: Visualization, Writing - review & editing
Search for more papers by this authorVittorio Giacomarra
Division of Otolaryngology, Santa Maria degli Angeli General Hospital, Pordenone, Italy
Contribution: Conceptualization, Data curation, Writing - review & editing
Search for more papers by this authorAntonino De Paoli
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Visualization, Writing - review & editing
Search for more papers by this authorRoberto Orecchia
Scientific Direction, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Supervision, Writing - review & editing
Search for more papers by this authorGiovanni Franchin
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Giovanni Franchin and Barbara Alicja Jereczek-Fossa are co-last authors.Contribution: Supervision, Writing - review & editing
Search for more papers by this authorBarbara Alicja Jereczek-Fossa
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
Giovanni Franchin and Barbara Alicja Jereczek-Fossa are co-last authors.Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorGiuseppe Fanetti
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Giuseppe Fanetti and Daniela Alterio are co-first authors.Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorDaniela Alterio
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Giuseppe Fanetti and Daniela Alterio are co-first authors.Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorCorresponding Author
Giulia Marvaso
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Correspondence
Giulia Marvaso, Department of Radiation Oncology, IEO, Istituto Europeo di Oncologia IRCCS, Via Ripamonti, 435, Milano 20141, Italy.
Email: [email protected]
Contribution: Conceptualization, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorSara Gandini
Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Formal analysis, Supervision, Validation
Search for more papers by this authorDamaris Patricia Rojas
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Conceptualization, Visualization, Writing - review & editing
Search for more papers by this authorCarlo Gobitti
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Formal analysis, Writing - review & editing
Search for more papers by this authorEmilio Minatel
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Conceptualization, Writing - review & editing
Search for more papers by this authorAlberto Revelant
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Conceptualization, Data curation, Writing - review & editing
Search for more papers by this authorAngela Caroli
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Conceptualization, Data curation, Validation, Writing - review & editing
Search for more papers by this authorClaudia Maria Francia
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Claudia Maria Francia: Affiliation at the time of the study.Contribution: Data curation, Validation, Writing - review & editing
Search for more papers by this authorOmbretta Alessandro
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
Contribution: Conceptualization, Writing - review & editing
Search for more papers by this authorMatteo Pepa
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Conceptualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorSimone Giovanni Gugliandolo
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Conceptualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorAnna Starzyńska
Department of Oral Surgery, Medical University of Gdańsk, Gdańsk, Poland
Contribution: Writing - review & editing
Search for more papers by this authorJerry Polesel
Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorEmanuela Vaccher
Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorMaria Cossu Rocca
Division of Uro-genital and Head and Neck Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Writing - review & editing
Search for more papers by this authorMarta Tagliabue
Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Formal analysis, Validation, Writing - review & editing
Search for more papers by this authorMohssen Ansarin
Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Data curation, Investigation, Writing - review & editing
Search for more papers by this authorValentina Lupato
Division of Otolaryngology, Santa Maria degli Angeli General Hospital, Pordenone, Italy
Contribution: Visualization, Writing - review & editing
Search for more papers by this authorVittorio Giacomarra
Division of Otolaryngology, Santa Maria degli Angeli General Hospital, Pordenone, Italy
Contribution: Conceptualization, Data curation, Writing - review & editing
Search for more papers by this authorAntonino De Paoli
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Contribution: Visualization, Writing - review & editing
Search for more papers by this authorRoberto Orecchia
Scientific Direction, IEO, European Institute of Oncology IRCCS, Milan, Italy
Contribution: Supervision, Writing - review & editing
Search for more papers by this authorGiovanni Franchin
Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
Giovanni Franchin and Barbara Alicja Jereczek-Fossa are co-last authors.Contribution: Supervision, Writing - review & editing
Search for more papers by this authorBarbara Alicja Jereczek-Fossa
Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
Giovanni Franchin and Barbara Alicja Jereczek-Fossa are co-last authors.Contribution: Conceptualization, Supervision, Writing - review & editing
Search for more papers by this authorFunding information
This study was partially funded by Accuray Inc. and by AIRC (Associazione Italiana per la Ricerca sul Cancro) (IG-14300).
Abstract
Aim
To evaluate the role of baseline neutrophil-to-lymphocyte ratio (NLR) as prognostic marker in squamous cell carcinoma of the oropharynx (OPC) treated with definitive chemoradiotherapy (CRT) in the era of HPV status.
Patients and methods
A retrospective analysis of 125 patients (pts) affected with locally advanced OPC was performed. Inclusion criteria were age >18 years, stage III or IV (TNM 7th ed.) and definitive CRT. Haematological marker for their independent role as prognostic biomarkers for progression-free survival (PFS) and overall survival (OS). Logistic models were used to assess the association with downstage in TNM 8th ed.
Results
Seventy-seven (61.6%) pts had HPV/p16 + related OPC. Therapeutic choice consisted in sequential and concurrent CRT. Median follow-up was 50 months. A value of NLR ≥3 was associated with poorer OS. Two-year OS was 91% and 81% in pts with NLR <3 and ≥3, respectively.
Conclusion
A baseline NLR ≥ 3 at treatment initiation represented a negative prognostic marker for OPC treated with definitive CRT. These results are in line with literature data, and prognostic value of NLR has been confirmed restaging our cohort with new TNM staging (8th ed.). Therefore, NLR could be considered a valuable biomarker for risk stratification in pts with OPC.
CONFLICT OF INTEREST
Matteo Pepa has received a research grant from Accuray Inc., and Simone Giovanni Gugliandolo has received a research grant from AIRC.
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