Prognostic Value of Hematological Parameters in Oral Squamous Cell Carcinoma
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 textgreater 14.3%, NLR (neutrophil–lymphocyte ratio) textgreater 3.38, PLR (platelet–lymphocyte ratio) textgreater 167.3, and SII (systemic inflammatory/immune response index) textgreater 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 textless 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 textgreater 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.
Citação
@online{lorenzo_fernandes_moça2023,
author = {Lorenzo Fernandes Moça , Trevisani and Isabelle Fernandes ,
Kulcsar and Marco Aurélio Vamondes , Kulcsar and Rogerio Aparecido ,
Dedivitis and Luiz Paulo , Kowalski and Leandro Luongo , Matos},
title = {Prognostic Value of Hematological Parameters in Oral Squamous
Cell Carcinoma},
volume = {15},
number = {21},
date = {2023-10-31},
doi = {10.3390/cancers15215245},
langid = {pt-BR},
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 textgreater 14.3\%, NLR
(neutrophil–lymphocyte ratio) textgreater 3.38, PLR
(platelet–lymphocyte ratio) textgreater 167.3, and SII (systemic
inflammatory/immune response index) textgreater 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
textless 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 textgreater 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.}
}