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. 2023 Oct 31;15(21):5245.
doi: 10.3390/cancers15215245.

Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma

Lorenzo Fernandes Moça Trevisani  1 , Isabelle Fernandes Kulcsar  2 , Marco Aurélio Vamondes Kulcsar  3 , Rogerio Aparecido Dedivitis  4 , Luiz Paulo Kowalski  5 , Leandro Luongo Matos  3   6
Affiliations

Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma

Lorenzo Fernandes Moça Trevisani et al. Cancers (Basel). .

Abstract

Introduction: Oral squamous cell carcinoma (OSCC) remains a significant public health concern. The variables utilized to determine appropriate treatment for this disease also represent its most unfavorable prognostic factors, with these parameters solely determined by the neoplasm and its behavior. However, a lack of well-established indices is evident in the literature that specifically relate to the patient and indicate a worse prognosis.

Objective: To assess the prognostic impact of hematological indices in patients with OSCC.

Methods: This retrospective cohort study included patients with oral squamous cell carcinoma (OSCC) who underwent curative-intent treatment. Treatment encompassed surgery, followed by adjuvant therapy, as necessary. Laboratory tests were conducted immediately prior to surgery, and demographic information was obtained from medical records.

Results: The cohort comprised 600 patients, with 73.5% being male subjects. Adjuvant treatment was recommended for 60.3% of patients. Throughout the follow-up period, 48.8% of participants died. Univariate analysis indicated that perineural invasion, angiolymphatic invasion, pT4 tumors, lymph node metastases, extranodal extravasation, RDW > 14.3%, NLR (neutrophil-lymphocyte ratio) > 3.38, PLR (platelet-lymphocyte ratio) > 167.3, and SII (systemic inflammatory/immune response index) > 416.1 were factors associated with increased mortality. These threshold values were established through ROC curve analysis. In the multivariate analysis, angiolymphatic invasion (HR = 1.43; 95% CI: 1.076-1.925; p = 0.014), pT4a/b tumors (HR = 1.761; 95% CI: 1.327-2.337; p < 0.001), extranodal extravasation (HR = 1.420; 95% CI: 1.047-1.926; p = 0.024), and RDW (HR = 1.541; 95% CI: 1.153-2.056; p = 0.003) were identified as independent risk factors for decreased overall survival.

Conclusions: RDW > 14.3% was proven to be a reliable parameter for assessing overall survival in patients with OSCC. Further studies are required to evaluate the clinical applicability of other hematological indices.

Keywords: RDW; oral squamous cell carcinoma; prognosis.

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Conflict of interest statement

All authors have read and approved the final manuscript and do not have actual, potential, or apparent conflict of interest about the manuscript submitted for review.

Figures

Figure 1
Figure 1
Kaplan–Meier curves demonstrating lower overall survival (p < 0.001; log-rank test for all comparisons) in OSCC patients with RDW > 14.3% (A), presence of angiolymphatic invasion (B), pT4-stage (C), and presence of extranodal extension of cervical metastases (D).
See this image and copyright information in PMC

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. INCA . Estimativa 2020: Incidência de Câncer No Brasil/Instituto Nacional de Câncer José Alencar Gomes da Silva. Volume 1 INCA; Rio de Janeiro, Brazil: 2019.
    1. Nemoto R.P., Victorino A.A., Pessoa G.B., Cunha L.L., Silva J.A., Kanda J.L., Matos L.L. Oral cancer preventive campaigns: Are we reaching the real target? Braz J. Otorhinolaryngol. 2015;81:44–49. doi: 10.1016/j.bjorl.2014.03.002. - DOI - PMC - PubMed
    1. Pinto F.R., Matos L.L., Gumz Segundo W., Vanni C.M., Rosa D.S., Kanda J.L. Tobacco and alcohol use after head and neck cancer treatment: Influence of the type of oncological treatment employed. Rev. Assoc. Med. Bras. 2011;57:171–176. doi: 10.1590/S0104-42302011000200014. - DOI - PubMed
    1. Halabi S., Owzar K. The importance of identifying and validating prognostic factors in oncology. Semin. Oncol. 2010;37:e9–e18. doi: 10.1053/j.seminoncol.2010.04.001. - DOI - PMC - PubMed

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