University of Khartoum

The Prediction Value of the Systemic Inflammation Score for Oral Cavity Squamous Cell Carcinoma

The Prediction Value of the Systemic Inflammation Score for Oral Cavity Squamous Cell Carcinoma

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Title: The Prediction Value of the Systemic Inflammation Score for Oral Cavity Squamous Cell Carcinoma
Author: Eltohami, Yousif Idris; FFDRCSI, MSc; MD, Huang-Kai Kao; Wei-Kai Lao, William; Yenlin Huang, MD; Abdelrahman, Mohamed; Ta Liao, Chun-; Chen Yen, Tzu-; Chang, Kai-Ping
Abstract: Objectives. This study aimed to investigate the potential prognostic role of the oral cancer systemic inflammation score (SIS) based on serum albumin levels and the lymphocyte-to-monocyte ratio in patients with oral squamous cell carcinoma (OSCC) after treatment. Study Design. A retrospective cohort study. Setting. Tertiary care center. Subjects and Methods. The study involved 613 patients who were treated for OSCC between September 2005 and December 2014. The association of the oral cancer SIS with various clinicopathological features was investigated. A nomogram based on different clinicopathological features and SIS was established to predict prognosis. Results. Higher SIS was significantly associated with older age (P = .0013), advanced tumor status (P \ .0001), tumor depth (P \ .0001), advanced overall pathologic stage (P \.0001), and extranodal extension (P = .0045), as well as the presence of perineural invasion (P = .0341). Higher SIS, older age, overall stage, and extranodal extension were demonstrated to be independent prognostic indicators for shorter overall survival (P \ .0001). A nomogram comprising SIS, TNM stage, and the degree of cell differentiation, as well as perineural invasion and extranodal extension, was developed to predict the prognosis of these patients. The c-index of the nomogram model based on TNM staging only was 0.688 and could be increased to 0.752 if SIS and several other clinicopathological parameters were incorporated. Conclusions. Higher SIS is associated with many poor prognosticators, and the nomogram that was established and based on the incorporation of SIS might strengthen the prediction of prognosis in patients with OSCC Head and neck cancers cause serious and challenging public health concerns and are collectively the sixth most common type of cancer worldwide. Among head and neck cancers, oral cavity cancer represents most cases.1 In 2008, Lambert et al2 reported that there were an estimated 260,000 patients with oral cavity cancer worldwide, with the majority residing in developing countries. Notably, smoking, drinking alcohol, and chewing betel nuts, as well as chronic inflammation, are the main predisposing factors for the tumorigenesis of oral squamous cell carcinoma (OSCC).3 Although recent advances in diagnosis and surgical management have improved treatment outcomes for patients with OSCC, some patients with OSCC still fail in locoregional recurrence or distant metastasis.1 The adoption of prognostic stratifications using clinical markers, in addition to the current staging system, might contribute to better treatment outcomes with suitable adjuvant therapies.
URI: http://khartoumspace.uofk.edu/123456789/27662


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