title: Pre-treatment neutrophil to lymphocyte ratio predicts the chemoradiotherapy outcome and survival in patients with oral squamous cell carcinoma: a retrospective study.
abstract: BACKGROUND
  The Neutrophil to lymphocyte ratio (NLR) has prognostic value in patients with a variety of cancers. However, its prognostic significance in oral squamous cell carcinoma (OSCC) patients has not been fully explored. The purpose of this study was to determine the clinical significance of NLR in patients with OSCC.
  
  
  METHODS
  OSCC patients who underwent surgery following 5-fluorouracil (5-FU)-based chemoradiotherapy were enrolled in this study. The associations between the NLR status and various clinicopathological features were examined, and the effects of the NLR on the prognosis were evaluated. Analysis of circulating interleukin-6 (IL-6) was carried out and correlation with NLR and C-reactive protein concentration (CRP) was examined.
  
  
  RESULTS
  An elevated NLR was significantly correlated with advanced T-stage and poor response to chemoradiotherapy. Moreover, a Cox regression analysis based on the disease-free survival (DFS) revealed the NLR status (hazard ratio, 2.013; P = 0.041) and pathological response to chemoradiotherapy (hazard ratio, 0.226; P = 0.001) to be significant prognostic factors in OSCC patients. Furthermore, circulating IL-6 was found to correlate with NLR and CRP.
  
  
  CONCLUSIONS
  The NLR is a potential biomarker for predicting the clinical response to 5-FU-based chemoradiotherapy and the survival in OSCC patients, and the systemic inflammatory response may be potential target for improving patient's prognosis.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. ricken.hikaru@gmail.com.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Nakashima
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. kokopelli205@gmail.com.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. ryoshida1126@gmail.com.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yoshida
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. nagatama0213@gmail.com.
authors.forename: Masashi
authors.initials: M
authors.lastname: Nagata
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. ahiro711@gmail.com.
authors.forename: Akiyuki
authors.initials: A
authors.lastname: Hirosue
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. k.k.ronbun@gmail.com.
authors.forename: Kenta
authors.initials: K
authors.lastname: Kawahara
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. j.sakata0510@gmail.com.
authors.forename: Junki
authors.initials: J
authors.lastname: Sakata
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. hidetaka.arita@gmail.com.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Arita
authors.affiliation: Section of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan. hiluckyhilucky@gmail.com.
authors.forename: Akimitsu
authors.initials: A
authors.lastname: Hiraki
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Life Sciences, Kumamoto University, Honjo 1-1-1, Chuo-ku, Kumamoto, 860-8556, Japan. hinakayam@gmail.com.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D053208:Kaplan-Meier Estimate; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein; D005472:Fluorouracil
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