Prognostic Value of Routine Blood Markers in Patients With Head and Neck Squamous Cell Carcinoma (HNSCC)

PURPOSE The levels of inflammatory blood markers, such as neutrophils, platelets, monocytes, and lymphocytes, can be informative for several cancer prognoses. However, the changes in other blood markers may be additional sources of prognostic information for cancer recurrence and survival. In this study, we aim to investigate the predictive value of non-inflammatory blood markers in HNSCC outcomes. METHOD In a retrospective cohort study, 522 primary HNSCC patients diagnosed between July 2010 and March 2023 were included. Clinicopathological characteristics and blood marker levels were collected and separated by their respective clinical cutoffs. Their associations with locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS) were evaluated using Cox proportional hazards regression with univariate and multivariate analyses. RESULTS The median follow-up was 34 months. The univariate analysis showed that hemoglobin (HR=0.56, 0.52, 0.32; p<0.004), MCHC (HR=0.51, 0.56, 0.38; p<0.014), and RDW (HR=1.93, 1.83, 2.14; p<0.0006) were each significantly associated with LRR, DFS, and OR. Meanwhile, albumin was significantly associated with DFS only (HR=0.49; 95% CI: 0.26-0.94; p=0.03). In multivariate analysis, BMI (HR=0.80; 95% CI: 0.67-0.96; p=0.01) and lymph vascular invasion (LVI) (HR=8.25; 95% CI: 1.68-40.5; p=0.009) were each significantly associated with OS. Among the routinely tested blood markers, RDW was shown to be an independent predictor of LRR (HR=3.54; 95% CI: 1.02-12.3; p=0.047) and OS (HR=11.2; 95% CI: 1.15-109.9; p=0.038). CONCLUSION Non-inflammatory blood markers can be potential informative markers on locoregional recurrence and overall survival in HNSCC patients.