To evaluate the role of baseline neutrophil-to-lymphocyte ratio (NLR) as prognostic marker in squamous cell carcinoma of the oropharynx (OPC) treated with definitive chemo-radiotherapy (CRT) in the era of HPV status.
A retrospective analysis of 125 patients (pts) affected with locally advanced OPC was performed. Inclusion criteria were age>18 years, stage III or IV (TNM 7 ed.), definitive CRT. Haematological marker for their independent role as prognostic biomarkers for progression-free survival (PFS) and overall survival (OS). Logistic models were used to assess the association with downstage in TNM 8 ed.
77 (61.6%) pts had HPV/p16+ related OPC. Therapeutic choice consisted in sequential and concurrent chemo- by concurrent CRT. Median follow-up was 50 months. A value of NLR≥3 was associated with poorer OS. Two-year OS was 91% and 81% in pts with NLR <3 and ≥3, respectively.
A baseline NLR ≥3 at treatment initiation represented a negative prognostic marker for OPC treated with definitive CRT. These results are in line with literature data and prognostic value of NLR has been confirmed restaging our cohort with new TNM staging (8 ed.). Therefore, NLR could be considered a valuable biomarker for risk stratification in pts with OPC.

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