Impact of hematological inflammatory markers on clinical outcome in patients with salivary duct carcinoma: a multi-institutional study in Japan

// Daisuke Kawakita 1 , Yuichiro Tada 2 , Yorihisa Imanishi 3 , Shintaro Beppu 1 , Kiyoaki Tsukahara 4 , Satoshi Kano 5 , Hiroyuki Ozawa 3 , Kenji Okami 6 , Yuichiro Sato 7 , Akira Shimizu 4 , Yukiko Sato 8 , Chihiro Fushimi 2 , Soichiro Takase 4 , Takuro Okada 2 , Hiroki Sato 4 , Kuninori Otsuka 3 , Yoshihiro Watanabe 3 , Akihiro Sakai 6 , Koji Ebisumoto 6 , Takafumi Togashi 7 , Yushi Ueki 7 , Hisayuki Ota 7 , Tomotaka Shimura 9 , Toyoyuki Hanazawa 10 , Shingo Murakami 1 , Toshitaka Nagao 9 1 Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan 2 Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan 3 Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan 4 Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan 5 Department of Otorhinolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan 6 Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan 7 Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan 8 Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan 9 Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan 10 Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan Correspondence to: Daisuke Kawakita, email: dk200811@gmail.com Keywords: salivary duct carcinoma, survival, mGPS, CRP, NLR Received: August 26, 2016      Accepted: November 09, 2016      Published: November 24, 2016 ABSTRACT The prognostic role of modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with salivary duct carcinoma (SDC) remains unclear. We conducted a multi-institutional retrospective cohort study of 140 SDC patients. The survival impact of these hematological markers was evaluated using multivariate proportional hazard models.High mGPS (≥1) was significantly associated with worse survival (3-year overall survival (OS): 16.7% vs 66.1%, p -value=0.003; 3-year progression-free survival (PFS): 0.0% vs 27.9%, p -value<0.001). Additionally, high C-reactive protein (CRP) (≥0.39 mg/dl) was significantly associated with worse survival (3-year OS: 32.1% vs 68.2%, p -value=0.001; 3-year PFS: 7.1% vs 31.1%, p -value<0.001). These associations were consistent with multivariate analysis adjusted for established prognostic factors. Although we also found significant association of high NLR (≥2.5) with OS (HR 1.80; 95% confidence interval, 1.05-3.08) in multivariate analysis, this association were inconsistent with the results of PFS. In addition, we found no significant associations of PLR with survival. In conclusion, we found that mGPS, CRP and NLR were identified as prognostic factors associated with survival in SDC patients.