Publication:

Neutrophil percentage-to-albumin ratio: is it useful in oropharyngeal cancer?

Background Host determinants, including nutritional status and systemic inflammation, are critical in the body's response to cancer. Neutrophil percentage-to-albumin ratio (NPAR) has emerged as a promising prognostic marker, however, its significance in head and neck cancer has yet to be fully established. This study aims to evaluate pretreatment NPAR as a predictor of disease-free survival, overall survival and cancer-specific survival in patients with oropharyngeal carcinoma.

Methods This retrospective cohort study included 88 patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) who underwent curative-intent treatment between January 1, 2010, and January 1, 2023. NPAR levels were assessed between diagnosis and treatment initiation. ROC analysis identified the optimal NPAR cutoff value of 16.09, which was used to categorize patients into low-NPAR and high-NPAR groups.

Results High NPAR (≥16.09) was significantly associated with tumor persistence or recurrence (OR=5.70; p<0.001). Disease-free survival, 5-year overall survival and 5-year cancer-specific survival were all significantly shorter among patients with NPAR ≥16.09. In fact, high-level NPAR group had over than 3-fold increased risk of cancer-specific death at 5 years (HR=3.440; p=0.006).

Conclusions Our findings indicate that a NPAR ≥16.09 may be associated with poorer outcomes in oropharyngeal cancer. While NPAR shows potential as a prognostic biomarker to complement the TNM staging system, further validation in larger, prospective studies is warranted.