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Prognostic value of pretreatment circulating neutrophils, monocytes, and lymphocytes in oropharyngeal cancer stratified by human papillomavirus status
Author(s) -
Huang Shao Hui,
Waldron John N.,
Milosevic Michael,
Shen Xiaowei,
Ringash Jolie,
Su Jie,
Tong Li,
PerezOrdonez Bayardo,
Weinreb Ilan,
Bayley Andrew J.,
Kim John,
Hope Andrew,
Cho B.C. John,
Giuliani Meredith,
Razak Albiruni,
Goldstein David,
Shi Willa,
Liu FeiFei,
Xu Wei,
O'Sullivan Brian
Publication year - 2015
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29100
Subject(s) - medicine , gastroenterology , hazard ratio , cohort , human papillomavirus , cervical cancer , cancer , multivariate analysis , oncology , confidence interval
BACKGROUND The objective of this study was to investigate the prognostic value of the pretreatment circulating neutrophil count (CNC), circulating monocyte count (CMC), and circulating lymphocyte count (CLC) in human papillomavirus (HPV)–related (HPV+) and HPV‐unrelated (HPV–) oropharyngeal cancer (OPC). METHODS All p16‐confirmed HPV+ and HPV– OPC cases treated with chemoradiotherapy from 2000 to 2010 were included. Overall survival (OS) and recurrence‐free survival (RFS) were compared for high and low CNCs, CMCs, and CLCs (dichotomized by median values). A multivariate analysis (MVA) confirmed their prognostic value in HPV+ and HPV– tumors, respectively. RESULTS Five hundred ten HPV+ OPC cases and 192 HPV– OPC cases were included. The HPV+ cohort had lower CNC and CMC values but a CLC similar to that of the HPV– patients ( P < .01). The median follow‐up was 4.8 years. In the HPV+ cohort, a high CNC or CMC correlated with reduced OS and RFS in comparison with a low CNC or CMC ( P < .01 for all), but no difference was evident in OS ( P = .30) or RFS ( P = .10) with the CLC. MVA confirmed that a higher CNC or CMC independently predicted lower OS (hazard ratio [HR] for CNC, 1.14, P < .01; HR for CMC, 2.95, P < .01) and lower RFS (HR for CNC, 1.11, P < .01; HR for CMC, 3.39, P < .01), whereas a higher CLC was associated with higher RFS (HR, 0.66, P = .03) and marginally higher OS (HR, 0.80, P = .08). In the HPV– cohort, CNC, CMC, and CLC were not predictive of OS ( P = .16, P = .86, and P = .14) or RFS ( P = .61, P = .59, and P = .62). CONCLUSIONS This relatively large cohort study demonstrates that a high CNC and a high CMC independently predict inferior OS and RFS, whereas a high CLC predicts better RFS and marginally better OS in HPV+ OPC patients. This association was not apparent in HPV– patients. Cancer 2015;121:545–555. © 2014 American Cancer Society .