Background: This study aimed to evaluate the derived neutrophil to lymphocyte ratio (dNLR) in predicting the prognosis of patients with locally advanced oral squamous cell carcinoma (LAOSCC) and to assess the survival benefits from docetaxel, cisplatin, and 5-fluorouracil (5-FU) (TPF) induction chemotherapy (IC). Methods: Patients from a phase III trial involving TPF IC in stage III/IVA OSCC patients (NCT01542931) were enrolled. Receiver operating characteristic curves were constructed, and the area under the curve was computed to determine dNLR cutoff points. Kaplan–Meier survival estimates and Cox proportional hazards models were used for longitudinal analysis. Results: A total of 224 patients were identified (median age: 55.4 years; range: 26 to 75 years; median follow-up: 90 months; range: 3.2 to 93 months). The cutoff point for the dNLR was 1.555. Multivariate analysis showed that the dNLR was an independent negative predictive factor for survival (overall survival (OS): hazard ratio (HR) = 1.154, 95% confidence interval (CI): 1.018–1.309,p= 0.025; disease-free survival (DFS): HR = 1.123, 95% CI: 1.000–1.260,p= 0.050; local recurrence-free survival (LRFS): HR = 1.134, 95% CI: 1.002–1.283,p= 0.047; distant metastasis-free survival (DMFS): HR = 1.146, 95% CI: 1.010–1.300,p= 0.035). A low dNLR combined with cTNM stage III disease predicted benefit from TPF IC for the patients [OS (χ2= 4.674,p= 0.031), DFS (χ2= 7.134,p= 0.008), LRFS (χ2= 5.937,p= 0.015), and DMFS (χ2= 4.832,p= 0.028)]. Conclusions: The dNLR is an independent negative predictive factor in LAOSCC patients. Patients with cTNM stage III disease and a low dNLR can benefit from TPF IC.
背景：本研究旨在评估衍生中性粒细胞与淋巴细胞比值（dNLR）对局部晚期口腔鳞状细胞癌（LAOSCC）患者预后的预测价值，并评估多西他赛、顺铂和5-氟尿嘧啶（5-FU）（TPF）诱导化疗（IC）的生存获益。方法：纳入一项针对III/IVA期OSCC患者的TPF IC III期临床试验（NCT01542931）的患者数据。通过构建受试者工作特征曲线并计算曲线下面积确定dNLR截断值。采用Kaplan-Meier生存估计和Cox比例风险模型进行纵向分析。结果：共纳入224例患者（中位年龄55.4岁，范围26-75岁；中位随访时间90个月，范围3.2-93个月）。dNLR截断值为1.555。多变量分析显示dNLR是生存的独立负向预测因素（总生存期（OS）：风险比（HR）=1.154，95%置信区间（CI）：1.018-1.309，p=0.025；无病生存期（DFS）：HR=1.123，95%CI：1.000-1.260，p=0.050；局部无复发生存期（LRFS）：HR=1.134，95%CI：1.002-1.283，p=0.047；无远处转移生存期（DMFS）：HR=1.146，95%CI：1.010-1.300，p=0.035）。低dNLR联合cTNM III期疾病可预测患者从TPF IC中获益[OS（χ²=4.674，p=0.031）、DFS（χ²=7.134，p=0.008）、LRFS（χ²=5.937，p=0.015）和DMFS（χ²=4.832，p=0.028）]。结论：dNLR是LAOSCC患者的独立负向预测因素。cTNM III期疾病伴低dNLR的患者可从TPF IC中获益。
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