Assessment of Pre-treatment Neutrophil-Lymphocyte ratio and Platelet- Lymphocyte ratio in prognosis of Oral Squamous Cell Carcinoma

Abstract Background Recent literature provides evidence of systemic inflammatory markers playing an important role in determining the disease free survival (DFS) and overall survival (OS) in oral squamous cell carcinoma (OSCC) patients. The aim of this study was to determine the prognosis of OSCC using preoperative Neutrophil-lymphocyte ratio (NLR) and platelet- lymphocyte ratio (PLR). Methods In our retrospective study, 130 patients with OSCC who received treatment for the same were enrolled. Both PLR and NLR was correlated with demographic data, tumour characteristics and prognosis. The optimal cut-off value of PLR and NLR was determined by Receiver Operating Characteristic (ROC) curve analysis and was set at 142 and 3.1 for PLR and NLR, respectively. The prognostic significance of both markers was determined by univariate and multivariate analysis. Survival curves were plotted using Kaplan-Meier method. Results Clinicopathologic variables were correlated with cumulative survival in univariate analysis; advanced cN 1 (p-0.001), pN 2 (p-0.001), pT 3 (p-0.049), pTNM 4 staging (p-0.006), patients who received multimodality treatment (p- 0.013) and those with high PLR (p-0.001) and NLR (p-0.002) showed a statistical significance, indicating a shorter disease free survival. Multivariate cox proportional hazard regression model demonstrated that a high PLR (Hazard ratio-2.998; 95% CI- 1.128- 7.968; p-0.028) and age (Hazard Ratio-1.100; 95% CI-0.750-1.613; p-0.025) were independent factors for determining disease free survival and overall survival. Conclusion We observed that a high PLR and NLR was significant in determining the prognosis. PLR was superior to NLR in determining the disease free survival (DFS) and overall survival (OS) and can be used as an independent prognostic indicator in OSCC.