Prognostic value of pre-treatment cardiovascular biomarkers in head and neck squamous cell carcinoma.

Objectives To examine the prognostic significance of pre-treatment C-reactive protein (CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) levels on all-cause mortality three years after head and neck squamous cell carcinoma (HNSCC) diagnosis. Subjects and methods Data from 118 consecutive HNSCC patients, treated between 2012 and 2015, were evaluated prospectively. The impact of CRP, high-sensitive (hs)-cTnT and NT-proBNP levels on the 3-year overall survival was estimated using the Kaplan-Meier method and Cox proportional hazard models. Results During the 36-month follow-up, 37 patients (31.35%) died. Multivariate analysis revealed that elevated CRP (Hazard ratio: 3.71, 95% CI: 1.44 - 9.53, P = 0.007) and NT-proBNP levels (Hazard ratio: 5.04, 95% CI: 2.02 - 12.55, P = 0.001) were associated to negative prognosis, independent on age, sex, smoking and alcohol status, TNM classification, tumor site, body mass index (BMI), systolic blood pressure (SBP), and treatment modality (except for radiotherapy). hs-cTnT had no influence over the prognosis, but it was correlated with TNM classification and SBP. CRP was significantly correlated with BMI and TNM classification, and NT-proBNP with SBP and hs-cTnT. Conclusions Pre-treatment CRP and NT-proBNP levels were identified as independent prognostic markers for poor clinical outcome three years after HNSCC diagnosis.