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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists

ORIGINAL ARTICLE Table of Contents   
Year : 2021  |  Volume : 25  |  Issue : 2  |  Page : 322-326
Neutrophil-to-lymphocyte ratio as a prognostic factor in oral squamous cell carcinoma – A single-institutional experience from a developing country

1 Department of Pathology, Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha, India
2 Department of Surgical Oncology, Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha, India

Correspondence Address:
Ranjana Giri
Department of Pathology, Kalinga Institute of Medical Sciences, KIIT, Bhubaneswar, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-029X.325235

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Background: Cell-mediated inflammatory response, neutrophils, lymphocytes and monocytes are being recognized as an important role in carcinogenesis. Neutrophil-to-lymphocyte ratio (NLR) has been used as an independent prognostic factor in varieties of cancers. NLR can be easily determined from complete blood count, and it could be considered as a simple and inexpensive prognostic marker. Aim: In this study, we evaluate the prognostic significance of NLR in patients with oral squamous cell carcinoma (OSCC). Materials and Methods: Clinical and epidemiological data of all biopsy-proven nonmetastatic OSCC treated between 2014 and 2018 were taken into consideration. Pretreatment absolute neutrophil and lymphocyte counts were used to get NLR. Using univariate and multivariate analysis, the impact of NLR on overall survival (OS) and progression-free survival (PFS) was investigated. Results: A total of 50 patients of OSCC with median pretreatment NLR ratio of 2.52 were identified. Based on the median NLR as a cutoff, patients were classified into two groups, i.e., high NLR and low NLR. Elevated NLR was significantly associated with lymph node metastasis (P = 0.01). Four-year OS and PFS were significantly better for patients with low NLR when compared with high NLR group (51.4% vs. 100%, P = 0.001). Four-year PFS for high and low NLR groups was 38.8% and 87.8% (P = 0.002). Multivariate analysis confirmed that NLR is an independent prognostic factor (P = 0.003). Conclusion: Pretreatment NLR provides a simple, cheap and early predictor of outcome in this group of patients. However, an optimal cutoff value of NLR should be determined, for which larger sample size and prospective studies are required.

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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007