Prognostic value of pretreatment lymphocyte-to-monocyte ratio in patients with advanced oral cavity cancer.

Introduction: Lymphocyte-to-monocyte ratio (LMR) has been reported as a prognostic factor in many cancers but the data are to date limited for its use in oral cavity cancer. The purpose of this study was to evaluate the prognostic value of LMR in advanced-stage oral cavity cancer. Methods: Data from 211 advanced-stage oral cancer patients treated with curative intent between January 2009 and December 2015 were obtained from the hospital information system. Pretreatment LMR and other hematologic parameters were recorded and an LMR cutoff value was calculated. Overall survival between the groups above (high LMR) and below (low LMR) the cutoff was compared and hazard ratios from univariate and multivariate analyses using a Cox proportional hazards model calculated. Results: Overall survival and disease-specific survival were better in the high LMR group. The 5-year overall survival rates were 31.6% and 15% in the high LMR and low LMR groups, respectively. Multivariate analysis using a Cox proportional hazards model showed that treatment modality and LMR were the only factors associated with overall survival. Conclusion: Low LMR was associated with poor survival outcome in patients with advanced-stage oral cavity cancer. Level of Evidence: 2b.

Long-term monitoring and predictive factors of critical weight loss among patients with nasopharyngeal carcinoma in a curative treatment setting.

PURPOSE: We aimed to determine weight change over time and identify risk factors of critical weight loss among patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: In this retrospective study, we investigated weight change over time in 445 patients with NPC who underwent curative treatment. Logistic regression analysis was used to identify possible predictors of critical weight loss. RESULTS: The incidence of critical weight loss was 67.87%. The long-term monitoring demonstrated a rapid weight loss, especially in the first 2 months of treatment, which continued up to 5 months. Patients with critical weight loss did not regain weight until 3 years. Univariate analysis showed that the following factors were significantly associated with critical weight loss: lower pretreatment body mass index (BMI), tumor stage, subjective global assessment score, Eastern Cooperative Oncology Group (ECOG) score, and enteral tube feeding. Multivariate analysis showed four factors that were associated with a lower critical weight loss: pretreatment BMI < 18.5 kg/m2 (p < 0.001, 95% confidence interval [CI] = 0.25 [0.12-0.52]), early tumor stage (p = 0.004, 95% CI = 0.46 [0.27-0.79]), ECOG grade II (p = 0.006, 95% CI = 0.15 [0.04-0.51]), and early prophylactic percutaneous gastrostomy (PEG) tube feeding (p = 0.001, 95% CI = 0.26 [0.12-0.59]). CONCLUSION: Patients having NPC with critical weight loss showed a significantly rapid decline in their weight in the first 2 months; the weight was persistently less than the baseline value during a 36-month follow-up period. Patients with lower BMI, early-stage cancer, and early prophylactic PEG tube feeding had a significantly lower critical weight loss than those without the abovementioned characteristics.

Removal of intraconal bullet through endoscopic transnasal surgery with image-guided navigation system 8 months after injury: a case report.

BACKGROUND: Lodgment of a bullet within the orbit is uncommon. The decision to remove these objects poses a challenge to surgeons due to a high risk of complications. Currently, endoscopic transnasal surgery with navigator assistance facilitates the localization of foreign bodies allowing their safe removal with minimal surrounding tissue damage or optic nerve injury. CASE PRESENTATION: We describe a case of a 26-year-old Thai woman with a chronic intraorbital foreign body located within her medial intraconal space. The chronic intraorbital foreign body was successfully removed by endoscopic transnasal surgery, combined with assistance from a navigation system, 8 months after injury without any damage to her eye or disturbance in vision. CONCLUSION: Intraconal foreign bodies, such as bullets, are a chronic problem and should be observed in the long term; prompt surgical removal should be performed if indicated.