Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation
Abstract Background Given the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-023-11062-3 |
| _version_ | 1797795673520734208 |
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| author | Brian Yu Sung Jun Ma Michael Khan Jasmin Gill Austin Iovoli Fatemeh Fekrmandi Mark K. Farrugia Kimberly Wooten Vishal Gupta Ryan McSpadden Moni A. Kuriakose Michael R. Markiewicz Ayham Al-Afif Wesley L. Hicks Mukund Seshadri Andrew D. Ray Elizabeth A. Repasky Anurag K. Singh |
| author_facet | Brian Yu Sung Jun Ma Michael Khan Jasmin Gill Austin Iovoli Fatemeh Fekrmandi Mark K. Farrugia Kimberly Wooten Vishal Gupta Ryan McSpadden Moni A. Kuriakose Michael R. Markiewicz Ayham Al-Afif Wesley L. Hicks Mukund Seshadri Andrew D. Ray Elizabeth A. Repasky Anurag K. Singh |
| author_sort | Brian Yu |
| collection | DOAJ |
| description | Abstract Background Given the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer. Methods A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan–Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias. Results A total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8–74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82–0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72–0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12–2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08–2.63, p = 0.02). Conclusion Low LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions. |
| first_indexed | 2024-03-13T03:21:34Z |
| format | Article |
| id | doaj.art-cb13876a50a8464da6ddcddeffcc4c6b |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-03-13T03:21:34Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-cb13876a50a8464da6ddcddeffcc4c6b2023-06-25T11:19:49ZengBMCBMC Cancer1471-24072023-06-0123111010.1186/s12885-023-11062-3Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiationBrian Yu0Sung Jun Ma1Michael Khan2Jasmin Gill3Austin Iovoli4Fatemeh Fekrmandi5Mark K. Farrugia6Kimberly Wooten7Vishal Gupta8Ryan McSpadden9Moni A. Kuriakose10Michael R. Markiewicz11Ayham Al-Afif12Wesley L. Hicks13Mukund Seshadri14Andrew D. Ray15Elizabeth A. Repasky16Anurag K. Singh17Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New YorkDepartment of Radiation Medicine, Roswell Park Comprehensive Cancer CenterJacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New YorkUniversity at Buffalo, The State University of New YorkDepartment of Radiation Medicine, Roswell Park Comprehensive Cancer CenterDepartment of Radiation Medicine, Roswell Park Comprehensive Cancer CenterDepartment of Radiation Medicine, Roswell Park Comprehensive Cancer CenterDepartment of Head and Neck Surgery, Roswell Park Comprehensive Cancer CenterDepartment of Head and Neck Surgery, Roswell Park Comprehensive Cancer CenterDepartment of Head and Neck Surgery, Roswell Park Comprehensive Cancer CenterDepartment of Head and Neck Surgery, Roswell Park Comprehensive Cancer CenterDepartment of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New YorkDepartment of Head and Neck Surgery, Roswell Park Comprehensive Cancer CenterDepartment of Head and Neck Surgery, Roswell Park Comprehensive Cancer CenterDepartment of Oral Oncology, Roswell Park Comprehensive Cancer CenterDepartment of Cancer Prevention and Control, Roswell Park Comprehensive Cancer CenterDepartment of Immunology, Roswell Park Comprehensive Cancer CenterDepartment of Radiation Medicine, Roswell Park Comprehensive Cancer CenterAbstract Background Given the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer. Methods A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan–Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias. Results A total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8–74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82–0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72–0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12–2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08–2.63, p = 0.02). Conclusion Low LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions.https://doi.org/10.1186/s12885-023-11062-3LMRLymphocyteMonocytechemoRTHN cancerHPV |
| spellingShingle | Brian Yu Sung Jun Ma Michael Khan Jasmin Gill Austin Iovoli Fatemeh Fekrmandi Mark K. Farrugia Kimberly Wooten Vishal Gupta Ryan McSpadden Moni A. Kuriakose Michael R. Markiewicz Ayham Al-Afif Wesley L. Hicks Mukund Seshadri Andrew D. Ray Elizabeth A. Repasky Anurag K. Singh Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation BMC Cancer LMR Lymphocyte Monocyte chemoRT HN cancer HPV |
| title | Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation |
| title_full | Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation |
| title_fullStr | Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation |
| title_full_unstemmed | Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation |
| title_short | Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation |
| title_sort | association of pre treatment lymphocyte monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation |
| topic | LMR Lymphocyte Monocyte chemoRT HN cancer HPV |
| url | https://doi.org/10.1186/s12885-023-11062-3 |
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