Ryohei Oya

Prognostic role of neutrophil-to-lymphocyte ratio in head and neck cancer: A meta-analysis

Neutrophils play substantial roles in cancer progression. Previous reports demonstrated the prognostic impact of the pretreatment neutrophil‐to‐lymphocyte ratio (NLR) in various types of solid cancers. The purpose of this study was to quantify the prognostic impact of NLR on head and neck squamous cell carcinoma (HNSCC).

Gadolinium-enhanced inner ear magnetic resonance imaging for evaluation of delayed endolymphatic hydrops, including a bilateral case.

Abstract Conclusion The data suggests that gadolinium-enhanced inner ear MR imaging is useful for diagnosis of delayed endolymphatic hydrops (DEH) because it is independent of inner ear function, and the size of the affected endolymphatic space is clearly enlarged. Objective This study was performed to semi-quantitatively evaluate the endolymphatic space in patients with all types of DEH using gadolinium-enhanced inner ear magnetic resonance (MR) imaging. Patients and methods Seven patients (age range = 21–77 years; five female, two male) with ipsilateral DEH (n = 5), contralateral DEH (n = 1), and bilateral DEH (n = 1). All patients underwent 3T MR imaging 4 h after intravenous injection of gadolinium. Software was used to determine the size of the endolymphatic space. Pure tone audiometry and caloric testing using an electronystagmogram were carried out. Results One side of the endolymphatic space was dominantly extended in patients with ipsilateral DEH, and both sides of the space were extended in patients with contralateral and bilateral DEH. In patients with ipsilateral DEH, the volume ratio of endolymph to vestibule was 2.5–4.3-times that in the unaffected ear. The volume ratio of endolymph to vestibule was nearly equal in patients with contralateral and bilateral DEH.

Prognostic role of neutrophil–lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis

Background Inflammatory markers are used to predict prognosis of nasopharyngeal carcinoma (NPC). Previous reports of neutrophil-to-lymphocyte ratio (NLR) and NPC mortality are inconsistent. This study aimed to quantify the prognostic impact of NLR on NPC. Methods The primary outcome was overall survival (OS), and the secondary outcomes were disease-specific survival (DSS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). We systematically searched electronic databases, identified articles reporting an association between NLR and NPC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and pooled HRs for each outcome were estimated using random effect models. Results Nine studies enrolling 5397 patients were included in the analyses. NLR greater than the cutoff value was associated with poor overall survival (HR 1.51, 95% CI 1.27–1.78), disease-specific survival (HR 1.44, 95% CI 1.22–1.71), progression-free survival (HR 1.53, 95% CI 1.22–1.90), and distant metastasis-free survival (HR 1.83, 95% CI 1.14–2.95). Conclusions Elevated NLR predicts worse OS, DSS, PFS and DMFS in patients with NPC.

Development and validation of a new comorbidity index for patients with head and neck squamous cell carcinoma in Japan

Due to habitual drinking and smoking and advanced age at diagnosis, patients with head and neck squamous cell carcinoma (HNSCC) frequently present with comorbidities. Several comorbidity indices have been developed and validated for HNSCC. However, none have become the standard method. In this study, we developed a new comorbidity index for Japanese patients with HNSCC, which was validated against an independent data set. A Cox proportional hazards analysis of 698 patients identified dementia, connective tissue diseases, and second primary malignancies in the oesophagus, head and neck, lungs, and stomach as prognostic comorbidities for overall survival. The Osaka head and neck comorbidity index (OHNCI) was generated from the weighted points of these comorbidities. In the independent data set, the 5-year overall survival rates for the low, moderate, and high scoring OHNCI groups were 62.1%, 64.3%, and 37.7%, respectively. In the multivariate analysis, the high scoring OHNCI group was an independent prognostic factor for overall survival (hazard ratio: 1.81, 95% confidence interval: 1.05–3.13; P = 0.031). The model including the OHNCI exhibited a higher prognostic capability compared to those including other commonly used comorbidity indices. The OHNCI could become the primary choice for comorbidity assessment in patients with HNSCC in Japan.

Age-adjusted Charlson Comorbidity Index predicts prognosis of laryngopharyngeal cancer treated with radiation therapy

Abstract Objectives: To examine the ability of comorbidity indices to predict the prognosis of laryngopharyngeal cancer and their association with treatment modalities. Methods: This retrospective study included 198 patients with laryngeal, hypopharyngeal, and oropharyngeal cancers. The effect of comorbidity indices on overall survival between surgery and (chemo)-radiation therapy ((C)RT) groups was analyzed. The cumulative incidence rates for cancer mortality and other mortalities according to the age-adjusted Charlson Comorbidity Index (ACCI) and Charlson Comorbidity Index (CCI) were compared. Results: Univariate survival analyses showed a significant association between the ACCI and overall survival in the (C)RT group, but not in the surgery group. The association between the CCI and overall survival was not significant in either group. In multivariate analyses, a high ACCI score was an independent prognostic factor in the (C)RT group (HR 2.89, 95% confidence interval (CI) 1.28–6.49), but not in the surgery group (HR 1.39, 95%CI 0.27–5.43). The higher ACCI group had increased mortality from other causes compared with the lower ACCI group (5-year cumulative incidence, 8.5% and 17.8%, respectively, p = .003). Conclusion: The ACCI was a better prognostic factor than the CCI. Surgery may be more beneficial than radiation for patients with a high ACCI.

Prognostic predictors of sudden sensorineural hearing loss in defibrinogenation therapy

Abstract Conclusions: Defibrinogenation therapy rather than corticosteroids therapy should be chosen for patients specifically with profound hearing loss and with initial high fibrinogen. Objectives: Corticosteroids therapy is the standard treatment for sudden sensorineural hearing loss (SSNHL) and prognostic factors by this therapy were reported. Defibrinogenation therapy is one of the treatment options for SSNHL. Aims of this study were to identify prognostic factors and correlative markers with hearing improvement in treating SSNHL by defibrinogenation therapy. Methods: During the early phase of the study, consecutive 61 patients were treated by defibrinogenation therapy with batroxobin (50 units), whereas corticosteroids (500 mg/day of hydrocortisone tapered by 9 days) were used for consecutive 64 patients during the late phase. Blood data that could predict a complete recovery were identified. Coagulation/fibrinolysis markers correlated with hearing improvement by defibrinogenation therapy were investigated. Results: Although there were no overall differences in hearing improvement between the two therapies, recovery rate in profound hearing loss patients was better in defibrinogenation therapy. In patients who showed complete recovery, serum fibrinogen level before treatment was significantly higher in the defibrinogenation group than the corticosteroid group. Responses of several fibrinolysis markers to defibrinogenation therapy evaluated by post-/pre-values were negatively correlated with hearing improvement.

Prognostic Significance of Hematologic Markers in Patients with Head and Neck Squamous Cell Carcinomas

Aim: To assess the prognostic value of hematologic markers for cancers of the head and neck region, according to tumor site. Methods: We reviewed the data of 441 patients diagnosed with head and neck squamous cell carcinomas (HNSCC) between 2006 and 2014. Overall survival rates were estimated using the Kaplan-Meier method and Cox proportional hazards models were used to assess the hazard ratio (HR) for death, according to hematologic markers. Results: In the univariate analyses, hemoglobin concentration; leukocyte, neutrophil, monocyte, and platelet counts; and the platelet-lymphocyte ratio were associated with overall survival. In the multivariate analyses, hemoglobin concentration (HR 0.55, 95% confidence interval [CI] 0.38 - 0.78, p < 0.001) and leukocyte (HR 1.57, 95% CI 1.11 - 2.23, p = 0.010), monocyte (HR 1.86, 95% CI 1.25 - 2.73, p = 0.003), and platelet (HR 2.17, 95% CI 1.24 - 3.57, p = 0.008) counts were independent prognostic factors for HNSCC. None of the hematologic markers were significant prognosticators for oral cancer. Leukocyte (HR 2.67, 95% CI 1.17 - 6.58, p = 0.018), monocyte (HR 4.04, 95%CI 1.85 - 8.56, p < 0.001), and platelet (HR 3.77, 95% CI 1.55 - 8.28, p = 0.005) counts were independent prognostic factors for laryngeal cancer. Conclusions: Several hematologic markers have prognostic significance for patients with HNSCC, however, the magnitude of the effect depends on the tumor site.

Platelet count and platelet-lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: A meta-analysis

Thrombocytosis is associated with the prognosis of various types of cancer. The purpose of this study was to quantify the prognostic impact of platelet count and platelet‐lymphocyte ratio (PLR) in head and neck squamous cell carcinoma (HNSCC).

Pretreatment serum lactate dehydrogenase as a prognostic indicator for oral cavity squamous cell carcinoma

Abstract Objectives: To examine whether lactate dehydrogenase (LDH) can predict the prognosis of oral cavity squamous cell carcinoma (OSCC) and to determine the optimal cut-off values for LDH. Methods: This retrospective study included 184 patients with OSCC, treated with surgery between 2006 and 2014. The association between LDH and T, N classification was investigated using the Mann-Whitney test. Cut-off values for LDH were determined with a recursive partitioning analysis (RPA). Survival rates were estimated using the Kaplan-Meier method. A Cox hazard model was used to assess the prognostic capability of LDH. Results: There was no association between LDH and T or N classification (p = .657, .619, respectively). RPA determined the cut-off values for LDH as 160 and 220 IU/L. The five year survival for low-, moderate-, and high-LDH groups were 87.7, 73.7, and 50.9%, respectively (p < .001). The hazard ratios (HRs) for death in moderate- and high-LDH groups were 2.92 (95%CI =1.02–12.30, p = .001) and 7.36 (95%CI =2.54–31.20, p < .001), respectively. The model including LDH-based stratification (Akaike’s information criterion (AIC) = 516) was better than the model including clinical stage (AIC =528). Conclusion: Pretreatment serum LDH is an independent prognostic factor for overall survival in patients with OSCC.

Longitudinal up‐regulation of endolymphatic hydrops in patients with Meniere's disease during medical treatment

Menieres disease (MD) is a common inner ear disease characterized by repeated episodic vertigo, fluctuating sensorineural hearing loss, and tinnitus. Its pathology is defined as endolymphatic hydrops (EH) in the inner ear and EH has been hypothesized to correlate with the clinical symptoms of MD. We presented the dynamics of in vivo EH in MD patients during medical treatments.