Pre-treatment Neutrophil-to-Lymphocyte Ratio as a predictor for occult cervical metastasis in early stage (T1-T2 cN0) squamous cell carcinoma of the oral tongue

Surg Oncol. 2018 Sep;27(3):503-507. doi: 10.1016/j.suronc.2018.06.002. Epub 2018 Jun 2.

Abstract

Background: Optimum management of clinically negative neck (cN0) remains controversial in early stage (T1-T2) squamous cell cancer of the oral tongue (OTSCC). The purpose of this study was to investigate the value of pre-treatment Neutrophil-to lymphocyte ratio (NLR) in predicting occult cervical metastasis in stage I and II OTSCC.

Methods: We carried out a retrospective chart review on 110 patients suffering from early stage OTSCC who were surgically treated with tumour excision and elective neck dissection (END). Our cohort was divided in pN+ and pN0 groups basing on histopathological examination after elective neck dissection. For each patient pre-treatment NLR was calculated.

Results: A statistically significant relationship between high levels of pre-treatment NLR and probability rate for neck occult metastases (0.000496 p-value) has been found. On our model the cut-off value was set for NLR >2.93. Above this level the probability to finding metastasis in a clinically negative neck increases exponentially.

Conclusion: These preliminary results offer clinicians an easily obtainable tool to stratify patients based on risks of metastatic node in whom END could be indicated.

Keywords: NLR; Neutrophil to lymphocyte ratio; Occult metastasis; Oral tongue squamous cell carcinoma; Pre-treatment hematological marker.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Staging
  • Neutrophils / pathology*
  • Tongue Neoplasms / pathology*
  • Tongue Neoplasms / surgery
  • Young Adult