Abstract

Introduction: The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) for nasopharyngeal carcinoma (NPC) continues to be debated. This study was conducted to enhance the accuracy of its prognostic value through a single-centre analysis.

Methods: Ninety-seven patients with NPC who received adjuvant radiotherapy between 1998 and 2022 were analyzed retrospectively.

Results: The study included a total of 97 patients who were treated for NPC and had available data. In 54 (56%) patients the NLR was ≤3 and in 43 (44%) the NLR was >3. The mean age of the patients was 49.64±14.51 (range: 12-82) years. Four patients were ≤18 years old and 93 patients were >19 years old. Sixty-three (65%) patients were male, 34 (35%) patients were female. For stage I patients, NLR was ≤3 in 2 (2%) and >3 in 2 (2%) patients. For stage II patients, NLR was ≤3 in 10 (11%) and >3 in 8 (8%) patients. For stage III patients, NLR was ≤3 in 29 (30%) and >3 in 25 (26%) patients. For stage IVA patients, NLR was ≤3 in 12 (12%) and >3 in 8 (8%) patients. For stage IVB patients, NLR was >3 in 1 (1%). The follow-up period was 79.4±72.1 (2-279) months. In all patients, mean overall survival (OS) was 159.37±13.66 (132.97-185.76) months, median 205±31.11 (144-265.99) months, The 1-, 2- , 3- and 5-year survival rates were 87.3%, 81.5%, 74.3%, and 65.3%, respectively. In general, 54 (56%) of the patients had NLR ≤3, while 43 (44%) had NLR >3. Mean survival times were 169.72±14.2 (95%CI 141.86-197.56) and 133.88±18.95 (95%CI 96.72-171.03) months for NLR ≤3 and NLR >3 patients, respectively. Median survival time was 223 months for NLR ≤3 patients, whereas it was 118±66.11 (95%CI 0-247.58) for >3 patients. The 1-, 2-, 3- and 5- year survival rates were 92.6%, 86.4%, 82% and 72.3% for NLR ≤3 and 80.3%, 75.6%, 65% and 56.8% for NLR >3 patients, respectively, indicating statistical significance (p=0.047).

Conclusion: In NPC, a pre-treatment NLR above three indicates an unfavorable prognosis in survival and may be a valuable prognostic biomarker. A large-scale prospective study is necessary to validate the prognostic significance of NLR in NPC patients and to determine precise cut-off values.

Keywords: nasopharyngeal carcinoma, neutrophil-to-lymphocyte ratio, survival

Copyright and license

Copyright © 1970 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Kandaz M, Balsak A, Çobanoğlu HB. The prognostic value of neutrophil-to-lymphocyte ratio in nasopharyngeal cancer. Northwestern Med J. 2025;5(1):16-24. https://doi.org/10.54307/2025.NWMJ.77

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