title: Utility of clinico-biological data for long-term prognosis of head and neck terminal cancer.
abstract: OBJECTIVE
  The prognosis of terminal head and neck cancer is traditionally determined using indices such as the palliative prognosis index. We aimed to develop an alternative prognosis index using clinico-biological data.
  
  
  METHODS
  This retrospective case-series study included 33 head and neck cancer patients whose cancer recurred despite receiving radiation therapy between April 2010 and April 2014. Clinico-biological data were collected the day patients were diagnosed as terminal. Bivariate correlation analyses were performed on survival times and clinico-biological data. For multivariate regression analyses, patients were divided into two groups: (1) patients who survived >120 days, and (2) those who survived <120 days. Group clinico-biological data were used to determine survival-time cutoff points for the prognosis index.
  
  
  RESULTS
  Bivariate analyses revealed significant correlations between survival time and BMI, hemoglobin, albumin, C-reactive protein (CRP), Onodera's Prognostic Nutritional Index (O-PNI), modified Glasgow Prognostic Score (mGPS), and Performance Status (PS). Multivariate analyses showed a strong correlation between survival time and BMI. The two groups differed significantly in BMI, albumin, CRP, O-PNI, and mGPS. In multivariate analyses BMI, CRP, and O-PNI differed significantly in the two groups.
  
  
  CONCLUSIONS
  BMI ≤16.4, CRP ≥1.01, and O-PNI ≤33.4 are significant predictors of long-term survival in terminal cancer patients.
authors.affiliation: a Department of Otorhinolaryngology , Japanese Red Cross Shizuoka Hospital , Shizuoka , Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: a Department of Otorhinolaryngology , Japanese Red Cross Shizuoka Hospital , Shizuoka , Japan.|b Department of Otorhinolaryngology, Head and Neck Surgery , Keio University, School of Medicine , Tokyo , Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Wasano
authors.affiliation: a Department of Otorhinolaryngology , Japanese Red Cross Shizuoka Hospital , Shizuoka , Japan.
authors.forename: Sayuri
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: a Department of Otorhinolaryngology , Japanese Red Cross Shizuoka Hospital , Shizuoka , Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tomisato
authors.affiliation: b Department of Otorhinolaryngology, Head and Neck Surgery , Keio University, School of Medicine , Tokyo , Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000401:mortality*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: BMI; CRP; O-PNI; Prognosis index; mortality