The inflammatory markers and locoregional pathological results both have an impact on the prognosis of oral squamous cell carcinoma in patients who have undergone neck dissection - 13/09/24

Doi : 10.1016/j.jormas.2024.102040

Kenji Yamagata ^a,^b,^⁎ , Rei Sawadaishi ^a, Shohei Takaoka ^a, Satoshi Fukuzawa ^a, Fumihiko Uchida ^a,^b, Naomi Ishibashi-Kanno ^a,^b, Hiroki Bukawa ^a,^b
^a Department of Oral and Maxillofacial Surgery, University of Tsukuba Hospital Tsukuba, Ibaraki 305-8576, Japan
^b Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan

^⁎Corresponding author. Kenji Yamagata, Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba1-1-1 TennodaiTsukubaIbaraki305-8575Japan

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 13 September 2024

Abstract

Background

Locoregional surgical pathology, with surgical margins at the primary site and lymph node (LN) metastasis, particularly extranodal extension (ENE), plays an important role in the prognosis of oral squamous cell carcinoma (OSCC). In addition, systemic inflammatory response and nutritional status are associated with poor prognosis.

Purpose

This study aimed to comprehensively assess the effect of inflammatory markers and locoregional factors on the prognosis of patients with OSCC who underwent neck dissection (ND).

Methods

This retrospective cohort study included patients who had undergone ND for OSCC between 2013 and 2021. The primary predictive variables were the weighted lymph node ratio (WLNR) and inflammatory markers. Primary outcome variables were overall survival (OS) and disease-free survival (DFS).

Results

Among 153 patients (99 males, 54 females), 55 (35.9 %) had LN metastasis and 11 (7.2 %) exhibited ENE. The inflammatory markers lymphocyte/monocyte ratio (LMR), monocyte/albumin ratio (MAR), C-reactive protein/albumin ratio (CAR), and WLNR demonstrated significant cut-off values for survival, with values of 4.805, 104.72, 0.041, and 0.0235, respectively. The Cox proportional hazards model revealed significant differences in age, WLNR, LMR, MAR, CAR, and vascular, lymphatic, and perineural invasion (Pn). Multivariate analysis indicated that the hazard ratios (95 % confidence intervals) for WLNR (3.416; 1.542–7.566), MAR (2.404; 1.254–4.607), and Pn (2.516; 1.291–4.905) were independent variables for OS.

Conclusions

In patients with OSCC who underwent ND, the inflammatory marker MAR and locoregional factors WLNR and Pn were simultaneously identified as prognostic factors.

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Keywords : Oral squamous cell carcinoma, Weighted lymph node ratio, Inflammatory marker, Perineural invasion, Monocyte/albumin ratio, Overall survival

Abbreviations : LN, ENE, OSCC, ND, WLNR, OS, LMR, MAR, CAR, V, LVI, Ly, Pn, HR, CI, DFS, RND, CT, MRI, PET-CT, US, UICC, pN, SPSS, AUC, NLR, PLR, PNI, PCI