Monocyte-to-lymphocyte ratio as a prognostic indicator in head and neck squamous cell carcinoma treated with radiotherapy

The monocyte-to-lymphocyte ratio (MLR) has been reported as a useful prognosticator in various types of cancers. We studied the usefulness of MLR as a prognosticator for head and neck squamous cell carcinoma (HNSCC) in patients with oropharyngeal, hypopharyngeal, and laryngeal cancer who received radical concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT).

This study included 76 HNSCC patients diagnosed between January 2015 and April 2020. We obtained their haematological records within one month before radiotherapy and calculated the MLR. Kaplan-Meier method and Cox proportional hazard model were performed to evaluate the association of MLR with locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS).

The Kaplan–Meier survival analysis for MLR showed a significant difference (p = 0.0326) in OS. Univariate and multivariate analysis revealed that the lower MLR group was associated with better OS (hazard ratio [HR] = 0.345, 95 % confidence interval [CI] = 0.124–0.960, p = 0.042 and HR = 0.305, 95% CI = 0.102-0.916, p = 0.034, respectively). Multivariate analysis also revealed that N 2-3 was significant independent predictor of LFRS and PFS (HR = 4.47, 95% CI = 1.43–14.0, p = 0.0286 and HR = 4.94, 95% CI = 1.84-13.2, p < 0.01, respectively).

MLR was useful as a prognostic predictor for OS in patients with HNSCC who received radical concurrent CRT or BRT. MLR may be more reflective of OS than of LRFS or PFS.