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Head and Neck Surgery

(007) A Predictive Survival Model for Stage IV Oropharyngeal Carcinoma Patients

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Peng Yeh, MD

    Resident
    Department of Otolaryngology, Far Eastern Memorial Hospital
    New Taipei City, New Taipei, Taiwan (Republic of China)

    • Co-Author(s)

  • Po-Wen Cheng

    Chief
    Department of Otolaryngology, Far Eastern Memorial Hospital
    New Taipei City, New Taipei, Taiwan (Republic of China)

    • Senior Author(s)

  • Wu-Chia Lo

    Attending Physician
    Department of Otolaryngology, Far Eastern Memorial Hospital
    New Taipei City, New Taipei, Taiwan (Republic of China)

Disclosure(s):
Peng Yeh, MD: No relevant relationships to disclose.
Po-Wen Cheng: No relevant relationships to disclose.
Wu-Chia Lo: No relevant relationships to disclose.


Introduction: This retrospective single institution study was intended to assess and understand the pre-treatment and post-treatment prognostic markers associated with rate of death at 1, 3 and 5 years in advanced oropharyngeal cancer (OPC) patients who were treated with CCRT with/without neoadjuvant CT. A nomogram was developed to predict rate of mortality at 1, 3 and 5 years in these patients.

Methods: We retrospectively reviewed patients who were diagnosed with advanced OPCs (stage IVA and IVB) between February 2008 and November 2019 at a single tertiary center (Far Eastern Memorial Hospital, New Taipei City, Taiwan). The patients were treatment with systemic therapy. We evaluated the pre-treatment and post-treatment laboratory data. We investigated five inflammatory indexes: LMR, NLR, PLR, SII, and SIRI. The primary outcomes in this study were disease-specific survival (DSS) and disease-free survival (DFS). A nomogram was generated to predict the DSS within 1, 3 and 5 years after treatment completion.

Results: A total of 128 eligible patients were enrolled. The multivariate logistic regression analyses using a forward stepwise Cox regression model adjusted for age and gender showed that pretreatment Hb < 12 g/dl (hazard ratio [HR] 2.551, 95% confidence interval [CI] 1.366–4.762, p = 0.003), pretreatment SII ≥ 1751 (HR 2.173, 95% CI 1.015–4.652, p = 0.046), and posttreatment SIRI ≥ 261 (HR 2.074, 95% CI 1.045–4.115, p = 0.037) were independent risk factors for worsened DSS, whilst pretreatment Hb < 12 g/dl (HR 1.692, 95% CI 1.019–2.809, p = 0.032), pretreatment SII ≥ 1751 (HR 1.968, 95% CI 1.061–3.650, p = 0.032), and posttreatment SII ≥ 1690 (HR 1.922, 95% CI 1.105–3.345, p = 0.021) were independent risk factors for worsened DFS within 5 years in advanced oropharyngeal cancer patients. The independent risk factors of DSS were used to create a nomogram for 1, 3, and 5 year DSS probability as well as median DSS time.

Conclusions: In summary, the pretreatment Hb, pretreatment SII, posttreatment SII, and posttreatment SIRI are important prognostic factors for advanced stage IV oropharyngeal cancers.