Serum inflammatory markers as prognostic marker for nasopharyngeal carcinoma with liver metastasis: a multi-center retrospective study

Eur Arch Otorhinolaryngol. 2024 Aug;281(8):4315-4324. doi: 10.1007/s00405-024-08649-2. Epub 2024 Apr 20.

Abstract

Background: This retrospective study investigated the prognostic value of serum inflammatory markers in nasopharyngeal carcinoma (NPC) patients, focusing on their association with overall survival (OS) and liver metastasis-free survival (LMFS).

Methods: The study included 314 NPC patients treated between 2010 and 2020. Clinical characteristics, treatment methods, and serum inflammatory markers were assessed. Patients were categorized into two groups of with and without liver metastasis. Univariate and multivariate Cox regression and Kaplan-Meier survival analyses were performed to investigate the prognostic value of serum inflammatory markers in NPC patients with and without liver metastasis.

Results: In the whole cohort, univariate Cox regression analysis singled out tumor necrosis factor-α (TNF-α) (HR = 1.57, 95% CI 1.44-4.90, p = 0.004) and neutrophil-to-lymphocyte ratio (NLR) (HR = 2.13, 95% CI 1.33-3.99, p = 0.009), which were significantly associated with poorer OS. In patients with liver metastasis, TNF-α and NLR could not independently predict OS. However, high TNF-α levels were independently associated with worse OS in patients without liver metastasis (HR (95% CI) = 2.75 (1.67-8.68), p < 0.001). High NLR levels could independently predict poor OS in both groups with (HR (95% CI) = 1.94 (1.77-6.38), p = 0.010) and without liver metastasis (HR (95% CI) = 1.58 (1.19-7.54), p = 0.009). Ultimately, TNF-α and NLR could not significantly predict LMFS.

Conclusion: This study highlights the prognostic significance of TNF-α and NLR in NPC patients, especially in those with liver metastasis. These inflammatory markers could serve as valuable indicators for assessing the prognosis of NPC patients. Further research is warranted to validate their clinical utility and explore potential therapeutic implications.

Keywords: NLR; Nasopharyngeal carcinoma; Overall survival; Serum inflammatory markers; TNF-α.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor* / blood
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms* / blood
  • Liver Neoplasms* / mortality
  • Liver Neoplasms* / secondary
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma* / blood
  • Nasopharyngeal Carcinoma* / mortality
  • Nasopharyngeal Carcinoma* / pathology
  • Nasopharyngeal Neoplasms* / blood
  • Nasopharyngeal Neoplasms* / mortality
  • Nasopharyngeal Neoplasms* / pathology
  • Neutrophils
  • Prognosis
  • Retrospective Studies
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Biomarkers, Tumor
  • Tumor Necrosis Factor-alpha