Abstract
This study aimed to evaluate the prognostic significance of the modified Glasgow prognostic
score (mGPS), neutrophil:lymphocyte ratio (NLR), and platelet:lymphocyte ratio (PLR)
in patients undergoing resection of oral squamous cell carcinoma (OSCC) with curative
intent. We also aimed to explore the relation between activated systemic inflammation
and adverse tumour characteristics. Between February 2006 and December 2019, data
on 825 patients undergoing curative resection of OSCC were retrospectively gathered.
Preoperative C-reactive protein and serum albumin levels were obtained to calculate
a mGPS. Full blood count parameters were collected to calculate NLR and PLR values.
Categorical factors were analysed using the chi squared test. Multivariate regression
was performed to identify independent prognostic variables and the predictive value
of each model generated. For disease-specific survival (DSS) and overall survival
(OS), mGPS (DSS and OS both p<0.001), NLR (DSS and OS both p<0.001) and PLR (DSS and
OS both p<0.001) were significant on univariate analysis. Independent predictive variables
for DSS included mGPS, clinical node stage, categorised depth of tumour invasion,
non-cohesive invasive front, and lymphovascular invasion. The concordance index was
acceptable (0.756) for this model. Replacing mGPS with NLR or PLR as a marker of systemic
inflammation demonstrated the same preoperative variables as independently predictive
for DSS. The concordance index for these models were acceptable (NLR 0.76 and PLR
0.756). The systemic inflammatory response is prognostically significant in patients
undergoing curative resection of OSCC. The potential link between an inflammatory
tumour microenvironment and activated systemic inflammation merits further investigation.
Keywords
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Article Info
Publication History
Published online: November 10, 2021
Accepted:
October 11,
2021
Received:
August 19,
2021
Identification
Copyright
© 2021 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
