Venous Thromboembolism Risk in Head and Neck Cancer: Significance of the Preoperative Platelet-to-Lymphocyte Ratio

Abstract (250 limit)ObjectiveWe aimed to investigate the association between the preoperative platelet-to-lymphocyte ratio (PLR) and venous thromboembolism (VTE) in head and neck cancer (HNC) patients undergoing major surgery.Study DesignRetrospective cohort studySettingAcademic tertiary hospital from 2011 to 2017Subjects and MethodsPatients with confirmed HNC undergoing major surgery were included in this study. The preoperative PLR was recorded for all patients. Known VTE risk factors, including age, sex, smoking, BMI, prior VTE, and anticoagulation were also recorded. Risk factors were screened in univariate analysis using Wilcoxon’s rank sum test and χ2 test (Bonferroni corrected). Significant covariates were subsequently included in a multivariate regression model. Bootstrap techniques were used to obtain credible confidence intervals (CI).ResultsThere were 306 patients enrolled with 7 cases of VTE (6 DVTs and 1 PE). On univariate analysis, length of stay (p = 0.0026), length of surgery (p = 0.0029), and PLR (p = 0.0002) were founded to have significant associations with VTE. A Receiver Operator Characteristic (ROC) curve was constructed, that yielded an AUROC of 0.905 (95% CI: 0.82 - 0.98). Using an optimized cutoff, the multivariate model showed that length of surgery (β 95% CI: 0.0001 - 0.0006; p = 0.0056), and PLR (β 95% CI: 5.3256 - 5.3868; p < 0.0001) were significant independent predictors of VTE.ConclusionThis exploratory pilot study has shown that PLR offers a potentially accurate risk stratification measure as an adjunct to current tools in VTE risk prediction, without additional cost to health systems.Oral PresentationThis data was presented as an oral presentation at the Annual American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNSF) Meeting, 13th September 2017

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Venous Thromboembolism Risk in Head and Neck Cancer: Significance of the Preoperative Platelet-to-Lymphocyte Ratio

Otolaryngology ◽

10.1177/0194599818756851 ◽

2018 ◽

Vol 159 (1) ◽

pp. 85-91 ◽

Cited By ~ 4

Author(s):

Tristan Tham ◽

Lauren Rahman ◽

Christina Persaud ◽

Caitlin Olson ◽

Peter Costantino

Keyword(s):

Head And Neck Cancer ◽

Venous Thromboembolism ◽

Head And Neck ◽

Neck Cancer ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio

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Role of systemic inflammatory markers (biomarkers) as important prognostic factors for survival in head and neck cancer

Biomedicine ◽

10.51248/.v41i4.1363 ◽

2021 ◽

Vol 41 (4) ◽

pp. 837-844

Author(s):

Das Sumana Maiti ◽

Dharmendra Singh ◽

Anjana Bose ◽

Siddhartha Das ◽

S Neena Prasad ◽

...

Keyword(s):

Head And Neck Cancer ◽

Prognostic Factors ◽

Head And Neck ◽

Neck Cancer ◽

Cox Regression ◽

Univariate Analysis ◽

Rank Test ◽

Head Neck Cancer ◽

Lymphocyte Ratio ◽

Definitive Therapy

Introduction and Aim: Cancer related inflammation is recognized as a critical multifaceted player in tumour initiation and progression. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are important markers of systemic inflammatory burden in malignancy. The present retrospective study aimed to evaluate the prognostic value of pre-treatment baseline (NLR) and (PLR) for survival in HNC patients. Materials and Methods: Analysis of data of 257 patients with head and neck cancer treated with definitive therapy over 3.5 yrs. Neutrophil, lymphocyte and platelet counts before treatment of all patients were collected and NLR and PLR were calculated. Results: Median value of NLR and PLR were 3.7 and 170.63 respectively. Receiver operator characteristics (ROC) curve analysis showed the predictive cut-off value of NLR and PLR as 3.9 and 158.3. Univariate analysis using Cox-regression model showed NLR (p < 0.001) and PLR (p = 0.001) significantly influenced the locoregional recurrence free survival (LRRFS) and overall survival (OS). The multivariate analysis showed NLR is the independent prognostic factors influencing LRRFS (p = 0.007) and OS (p = 0.002). Kaplan-Meier survival curve (Log rank test; Chi-square (?2) value) showed OS is significantly influenced by NLR group (LRRFS; ?2 = 23.9 and OS; ?2 = 33.7) and PLR group (LRRFS; ?2 = 11.2 and OS; ?2 = 19.3) in contrast to LRRFS. Conclusion: NLR can be strongly used as biomarker for prognostication for outcome and survival in head neck cancer. However, a well-designed, larger studies with longer follow-up is warranted.

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Acute kidney injury in head and neck cancer patients treated with chemoradiation with cisplatin: A single-center cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e17559 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e17559-e17559

Author(s):

Esther Van Meerten ◽

Catherine Owusuaa ◽

Ewout Hoorn ◽

Esther Oomen De Hoop

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Univariate Analysis ◽

Kidney Injury ◽

Tertiary Center ◽

Kdigo Guidelines ◽

Independent Risk Factors

e17559 Background: Patients with advanced head and neck cancer (HNC) are commonly treated with chemoradiation with concomitant cisplatin. Acute kidney injury (AKI) is considered a dose-limiting toxicity of cisplatin. We aim to describe the incidence and risk factors of AKI. Methods: In our tertiary center, we retrospectively identified 261 patients with advanced HNC and adequate renal function who were treated curatively from 2008 to 2015 using radiotherapy and concurrent three-weekly cisplatin. Outcome was the first AKI episode, defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines as a ≥50% rise in serum creatinine compared to baseline. Several potential predictors were investigated by means of logistic regression analyses. Results: In our cohort (mean age 58 ± 8 years, 74.3% male), a total of 102 (39.1%) patients developed AKI. Factors significantly associated with AKI in the univariate analysis were: age, alcohol consumption, excessive smoking, diabetes, hypertension, diuretic use, renin-angiotensin-aldosterone-system blockers, and administration of furosemide when indicated during first cisplatin cycle. In the multivariable model smoking 6-25 and > 25 cigarettes per day (OR 1.85; 95% CI 1.01-3.39 and OR 3.22; 95% CI 1.34-7.70, respectively), diabetes (OR 2.58; 95% CI, 1.01-6.61), furosemide (OR 2.39; 95% CI, 1.36-4.18) , and hypertension (OR 2.79; 95% CI, 1.52-5.12) remained independent risk factors for AKI. Conclusions: The identified risk factors smoking, diabetes, and hypertension may have caused pre-existing kidney damage and therefore have predisposed to AKI. Co-administration of furosemide with cisplatin is a potentially reversible risk factor for AKI.

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The Risk Factors of Head and Neck Cancer and Their General Patterns in Australia: A Descriptive Review and Update

Journal of Environmental Pathology Toxicology and Oncology ◽

10.1615/jenvironpatholtoxicoloncol.2014010130 ◽

2014 ◽

Vol 33 (1) ◽

pp. 45-57 ◽

Cited By ~ 4

Author(s):

Jagtar Singh ◽

Ramya Ramamoorthi ◽

Siddhartha Baxi ◽

Rama` Jayaraj ◽

Mahiban Thomas

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer

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Analysing the risk factors in the incidence of Osteoradionecrosis in head and neck cancer patients: A case series

10.26226/morressier.5af5cdae738ab1001baf50e2 ◽

2018 ◽

Author(s):

Zain Iqbal

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Case Series

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Combining Carcinoembryonic Antigen and Platelet to Lymphocyte Ratio to Predict Brain Metastasis of Resected Lung Adenocarcinoma Patients

BioMed Research International ◽

10.1155/2017/8076384 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Wei Wang ◽

Chao Bian ◽

Di Xia ◽

Jin-Xi He ◽

Ping Hai ◽

...

Keyword(s):

Risk Factors ◽

Brain Metastasis ◽

Lung Adenocarcinoma ◽

Carcinoembryonic Antigen ◽

Roc Curve ◽

Univariate Analysis ◽

Significant Risk ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Increased Risk

We aimed to evaluate the role of pretreatment carcinoembryonic antigen (CEA) and platelet to lymphocyte ratio (PLR) in predicting brain metastasis after radical surgery for lung adenocarcinoma patients. The records of 103 patients with completely resected lung adenocarcinoma between 2013 and 2014 were reviewed. Clinicopathologic characteristics of these patients were assessed in the Cox proportional hazards regression model. Brain metastasis occurred in 12 patients (11.6%). On univariate analysis, N2 stage (P = 0.013), stage III (P = 0.016), increased CEA level (P = 0.006), and higher PLR value (P = 0.020) before treatment were associated with an increased risk of developing brain metastasis. In multivariate model analysis, CEA above 5.2 ng/mL (P = 0.014) and PLR ≥ 120 (P = 0.036) remained as the risk factors for brain metastasis. The combination of CEA and PLR was superior to CEA or PLR alone in predicting brain metastasis according to the receiver operating characteristic (ROC) curve analysis (area under ROC curve, AUC 0.872 versus 0.784 versus 0.704). Pretreatment CEA and PLR are independent and significant risk factors for occurrence of brain metastasis in resected lung adenocarcinoma patients. Combining these two factors may improve the predictability of brain metastasis.

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