Role of systemic inflammatory markers (biomarkers) as important prognostic factors for survival in head and neck cancer


  • Das Sumana Maiti Dept. of Radio-Therapy, Institute of Post-Graduate Medical Education and Research, Kolkata, 700020, West Bengal, India
  • Dharmendra Singh All India Institute of Medical Sciences, Patna, Bihar, India
  • Anjana Bose Dept. of Anesthesiology, Diamond Harbour Govt. Medical College Hospital, Diamond Harbour, South 24 Parganas, West Bengal, 743331, India
  • Siddhartha Das Dept. of Physiology, Diamond Harbour Govt. Medical College Hospital, Diamond Harbour, South 24 Parganas, West Bengal, 743331, India
  • S. Neena Prasad Dept. of Radio-Therapy, Institute of Post-Graduate Medical Education and Research, Kolkata, 700020, West Bengal, India
  • Aloke Ghosh Dastidar Dept. of Radio-Therapy, Institute of Post-Graduate Medical Education and Research, Kolkata, 700020, West Bengal, India



NLR, PLR, prognostic factors, head neck cancer (HNC)


Introduction and Aim: Cancer related inflammation is recognized as a critical multifaceted player in tumour initiation and progression. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are important markers of systemic inflammatory burden in malignancy. The present retrospective study aimed to evaluate the prognostic value of pre-treatment baseline (NLR) and (PLR) for survival in HNC patients.


Materials and Methods: Analysis of data of 257 patients with head and neck cancer treated with definitive therapy over 3.5 yrs. Neutrophil, lymphocyte and platelet counts before treatment of all patients were collected and NLR and PLR were calculated.


Results: Median value of NLR and PLR were 3.7 and 170.63 respectively. Receiver operator characteristics (ROC) curve analysis showed the predictive cut-off value of NLR and PLR as 3.9 and 158.3. Univariate analysis using Cox-regression model showed NLR (p < 0.001) and PLR (p = 0.001) significantly influenced the locoregional recurrence free survival (LRRFS) and overall survival (OS). The multivariate analysis showed NLR is the independent prognostic factors influencing LRRFS (p = 0.007) and OS (p = 0.002). Kaplan-Meier survival curve (Log rank test; Chi-square (?2) value) showed OS is significantly influenced by NLR group (LRRFS; ?2 = 23.9 and OS; ?2 = 33.7) and PLR group (LRRFS; ?2 = 11.2 and OS; ?2 = 19.3) in contrast to LRRFS.


Conclusion: NLR can be strongly used as biomarker for prognostication for outcome and survival in head neck cancer. However, a well-designed, larger studies with longer follow-up is warranted.


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How to Cite

Sumana Maiti D, Singh D, Bose A, Das S, Neena Prasad S, Dastidar AG. Role of systemic inflammatory markers (biomarkers) as important prognostic factors for survival in head and neck cancer. Biomedicine [Internet]. 2021Dec.31 [cited 2022Jan.20];41(4):837-44. Available from:



Original Research Articles