Evaluation of Time to Surgery and Its Effect on Prognosis in Head and Neck Cancer.

BACKGROUND: Recently, time to treatment initiation has been observed to be increasing specifically for head and neck cancer. It is acknowledged that the pattern of increase is reflective of the use of sophisticated diagnostic and therapeutic techniques but was also determined to affect survival. OBJECTIVES: Our study sought to further investigate time to surgery (TTS) for surgically treated patients to see whether TTS would influence patient survival. METHOD: TTS was defined as the time from the earliest pathological report or scan, whichever was earlier, to surgery. The endpoints were overall survival (OS) and event-free survival (EFS). RESULTS: A total of 294 patients with head and neck cancer were included. Patients were organized into TTS quartiles of 0-14 days (quartile 1), 15-29 days (quartile 2), 30-49 days (quartile 3), and ≥50 days (quartile 4). The median follow-up time was 651 days, and the median TTS was 32 days. Using a univariable analysis of Cox regression, TTS was not significantly associated with OS or EFS. Kaplan-Meier curves were not significant for OS (p = 0.8904) and EFS (p = 0.9556). CONCLUSION: In this cohort study, we could not conclude that TTS was associated with OS or EFS.

Evaluation of the prognostic utility of the combination of platelet count with mean platelet volume as a prognostic indicator in head and neck cancer.

The combination of platelet count to mean platelet volume (COP-MPV) has been recently reported as a prognostic indicator of oral cavity cancer and other cancer sites. The aim of the present study was to validate the utility of the COP-MPV as a prognostic indicator in all head and neck cancer (HNC) sites. The clinicopathological characteristics of the COP-MPV with HNC were also investigated. This is a retrospective cohort study that recruited consecutively treated patients at a tertiary level academic hospital. Clinicopathological characteristics were recorded, including the COP-MPV scores. Survival was analyzed using Kaplan-Meier analysis, as well as multivariate Cox Proportional Hazards regression. COP-MPV was not associated with the survival outcome in univariate or multivariate analysis. In the multivariate model, tumor differentiation, tumor stage, nodal stage, surgical margins and hemoglobin were revealed to be significantly associated with survival. The results demonstrated that the COP-MPV is not a suitable prognostic factor for HNC.

Evaluation of the prognostic utility of the hemoglobin-to-red cell distribution width ratio in head and neck cancer.

PURPOSE: Hemoglobin is a known prognostic marker in many cancers, including head and neck cancer (HNC). There is some evidence that the red cell distribution width, which is an index of variation in size of red blood cells (RBCs), might be associated with prognosis as well. Recently, a novel prognostic biomarker has been reported-the ratio of the hemoglobin-to-red cell distribution width (Hb/RDW). Our objective was to evaluate the prognostic utility of the pretreatment Hb/RDW in HNC, controlled with known prognostic indices. METHODS: Retrospective cohort study in a tertiary academic hospital setting. Patients diagnosed with HNC treated with curative-intent surgery were eligible. Metastatic disease was excluded. The variables collected were age, sex, BMI, alcohol/tobacco exposure, performance scores, ACE-27, tumor characteristics, adjuvant treatment, and lab values. The primary endpoints were event-free survival (EFS) and overall survival (OS). OS was defined as time from start of treatment to death from any cause, and EFS was defined as time from start of treatment to any progression, recurrence, or death from any cause. Univariate and multivariate survival analysis was performed on the primary endpoints. RESULTS: A total of 205 patients were enrolled from 2010 to 2016. In multivariate analysis, the factors independently associated with EFS were BMI (p = 0.0364), advanced T stage (p = 0.001), and low Hb/RDW ratio (p = 0.017). The factors independently associated with OS were ECOG score (p = 0.042), advanced T stage (p < 0.0001), positive nodes (p = 0.0195), and Hemoglobin (0.0134). CONCLUSION: A low Hb/RDW ratio was associated with poorer EFS (HR = 2.02, 95% CI 1.13-3.61, p = 0.017), but was not associated with OS. This is the first study reporting the prognostic utility of Hb:RDW in head and neck cancer.