1 Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Sudan.
Otolaryngol Head Neck Surg. 2018 Jun;158(6):1042-1050. doi: 10.1177/0194599817751678. Epub 2018 Jan 16.
Objectives This study aimed to investigate the potential prognostic role of the oral cancer systemic inflammation score (SIS) based on serum albumin levels and the lymphocyte-to-monocyte ratio in patients with oral squamous cell carcinoma (OSCC) after treatment. Study Design A retrospective cohort study. Setting Tertiary care center. Subjects and Methods The study involved 613 patients who were treated for OSCC between September 2005 and December 2014. The association of the oral cancer SIS with various clinicopathological features was investigated. A nomogram based on different clinicopathological features and SIS was established to predict prognosis. Results Higher SIS was significantly associated with older age ( P = .0013), advanced tumor status ( P < .0001), tumor depth ( P < .0001), advanced overall pathologic stage ( P < .0001), and extranodal extension ( P = .0045), as well as the presence of perineural invasion ( P = .0341). Higher SIS, older age, overall stage, and extranodal extension were demonstrated to be independent prognostic indicators for shorter overall survival ( P < .0001). A nomogram comprising SIS, TNM stage, and the degree of cell differentiation, as well as perineural invasion and extranodal extension, was developed to predict the prognosis of these patients. The c-index of the nomogram model based on TNM staging only was 0.688 and could be increased to 0.752 if SIS and several other clinicopathological parameters were incorporated. Conclusions Higher SIS is associated with many poor prognosticators, and the nomogram that was established and based on the incorporation of SIS might strengthen the prediction of prognosis in patients with OSCC.
目的 本研究旨在探讨基于血清白蛋白水平和淋巴细胞与单核细胞比值的口腔癌系统性炎症评分(SIS)在口腔鳞状细胞癌(OSCC)患者治疗后的潜在预后作用。 研究设计 回顾性队列研究。 地点 三级护理中心。 受试者和方法 该研究纳入了 2005 年 9 月至 2014 年 12 月期间接受 OSCC 治疗的 613 例患者。研究调查了口腔癌 SIS 与各种临床病理特征的关系。基于不同的临床病理特征和 SIS 建立了列线图,以预测预后。 结果 较高的 SIS 与年龄较大(P=0.0013)、肿瘤进展程度较高(P<0.0001)、肿瘤深度较大(P<0.0001)、整体病理分期较高(P<0.0001)和淋巴结外扩展(P=0.0045)以及神经周围侵犯(P=0.0341)显著相关。较高的 SIS、年龄较大、总分期和淋巴结外扩展被证明是总生存期较短的独立预后指标(P<0.0001)。一个包含 SIS、TNM 分期、细胞分化程度以及神经周围侵犯和淋巴结外扩展的列线图被开发出来,以预测这些患者的预后。仅基于 TNM 分期的列线图模型的 c 指数为 0.688,如果将 SIS 和其他一些临床病理参数纳入,则可提高至 0.752。 结论 较高的 SIS 与许多预后不良因素相关,建立的包含 SIS 的列线图可能会增强对 OSCC 患者预后的预测。