preprints.org > medicine and pharmacology > oncology and oncogenics > doi: 10.20944/preprints202307.1184.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 17 July 2023 / Approved: 18 July 2023 / Online: 18 July 2023 (07:38:43 CEST)

Introduction: The identification of some prognostic markers in head and neck cancers (HNC) is necessary for the stratification of the therapeutic approach with benefits in increasing treatment response rates and limiting the toxic side effects of treatments. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and pallets-to-lymphocyte ratio (PLR) are currently validated as cheap and accessible biomarkers in different types of solid tumors. The purpose of the study was to evaluate the possible biomarker value of NLR, PLR and MLR recorded pre-treatment (radiotherapy/chemotherapy) for prognostic purposes in HNC. Materials and methods: The study included 190 patients with HNC included in the oncology record in the oncology outpatient clinic of the Craiova County Emergency Hospital starting from January 2002 and deceased until December 2022. Among them, 40 patients treated multimodally in the Clinic were included in the study of Oncology of the Craiova County Emergency Hospital for which the pre-treatment value (chemotherapy/radiotherapy) of NLR, PLR and MLR could be calculated. Overall survival (OS) values were correlated with NLR, PLR and MLR. Results: Median values for NLR, PLR and MLR were 6.15 (1.24-69), 200.79 (61.3- 1775.0) and 0.53 (0.12-5.5) respectively. In the study, the mean values for NLR, PLR and MLR of 2.88, 142.97 and 0.36 respectively were obtained. Median OS in the study group was 11 months (1-120). Although a negative Pearson`s correlation, the relationship between your variables was only weak, values R =.07, p=.67; R=.02, p=.31 and R=07, p=.62 being related with NLR, PLR and MLR respectively correlation with overall survival (OS). The median values of NLR, PLR and MLR were calculated (1.53, 90.32 and 0.18 respectively) for HNC cases with pre-treatment values of NLR <2 and for HNC cases with NLR values ≥6 (23.5, 232.78 and 0.79 respectively). Median OS for cases with NLR<2 and NLR≥6 were 17.4 and 13 months, respectively. Conclusions: The negative correlations of NLR, PLR and MLR with OS reported in the study are in accordance with the data reported in the literature for locally advanced recurrent and metastatic HNSCC cases. The comparative analysis of the data in the group with NLR<2 and NLR≥6 highlights an advantage of 4.4 months in median OS in favor of the group with low values of NLR. Being cheap and accessible, these markers could change the therapeutic approach even in centers with limited resources. The role of borderline NLR values as a prognostic factor in HNSCC must also be defined. PLR and MLR are less evaluated as biomarkers but the study demonstrates their potential to be used as prognostic biomarkers, it remains to be clarified if their inclusion in multivariable models along with NLR would bring a benefit

head and neck cancers, HNC, HNSCC, NLR, PLR, MLR, biomarkers, prognostic

Medicine and Pharmacology, Oncology and Oncogenics

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