Neutrophil to Lymphocyte and Lymphocyte to Monocyte Ratios Predict Improved Survival and Response to Induction Chemotherapy in Locally Advanced Squamous Cell Carcinoma of the Larynx.

Abstract

University of Michigan Cancer Center (UMCC) protocol 9520 treated stage III/IV locally advanced squamous cell carcinoma of the larynx (LASCCL) with cisplatin and 5-fluorouracil to select for definitive therapy based on response. Studies have shown that neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) are potential prognostic markers in p16-negative LASCCL. This study analyzes the predictive value of NLR and LMR. Samples from 193 LASCCL patients treated with chemotherapy were reviewed. Response to induction chemotherapy was tested with logistic regression. Optimal cut-points were determined by Youden's index. Survival was tested with Cox proportional hazards models. LMR had a positive association, NLR had a negative association with response to chemotherapy (p = 0.004;0.07). Response was higher in patients with LMR ≥ 2.8 (p = 0.0007) and NLR ≤ 2.8 (p = 0.04). Overall and disease-specific survival improved with LMR ≥ 2.8 (p = 0.0002;0.004) and NLR ≤ 2.8 (p = 0.10;0.03). Low NLR and high LMR were associated with favorable responses to chemotherapy and survival in LASCCL.