(0742) The Prognostic Value of Neutrophil-Lymphocyte Ratio on Outcomes in Patients With Head and Neck Cancer

Introduction: Inflammation has been shown to have a large role in cancer initiation and progression. Neutrophil-lymphocyte ratio (NLR) can be used as a marker of overall systemic inflammation and has been shown to have prognostic value in multiple malignancies, including head and neck cancer. The primary aim of this study is to assess the prognostic value of NLR in newly diagnosed head and neck cancer patients who were treated with chemoradiation and were current smokers at diagnosis.

Methods: Patients diagnosed with head and neck cancer at OU medical center between 2006 and 2021 were identified. Clinical and demographic information was retrospectively collected. 208 patients who were current smokers at diagnosis and were treated with chemoradiation with or without surgery with an intent to cure were included. Patients were further separated into two groups based on NLR at time of diagnosis: High NLR (≥5.71) and Low NLR ( < 5.71). Primary outcomes included response to first line therapy, disease-free survival, and overall survival.

Results: A total of 208 patients with head and neck squamous cell carcinoma who were treated with intent to cure were included. 83% of our population was male with a median age of 58. 94% had advanced T3 and T4 tumors. 52 patients were found to have high NLR. There were no differences between the NLR groups based on age, sex, race, stage, primary site, or treatment group. The high NLR group was found to have a 1.3 times higher risk of death and 1.4 times higher risk of recurrence compared to the low NLR group, although neither was statistically significant (p=0.45 and 0.26 respectively).

Conclusions: Although patients with high NLR had increased mortality and rate of recurrence, a NLR cutoff of 5.71 did not associate with a significant difference in survival outcomes in our specific population. More research is needed to more fully understand the prognostic value of NLR and the role of inflammatory markers on outcomes in head and neck cancer.