Prognostic impact of pretherapeutic laboratory values in head and neck cancer patients.

OBJECTIVE

The high comorbidity in patients with head and neck cancer (HNC) is mainly caused by the high incidence of tobacco and alcohol abuse and has direct impact on overall survival. We investigated whether HNC and its comorbidity also influence routine laboratory values and whether these values have influence on overall survival.

METHODS

A retrospective cohort of 261 patients with primary squamous cell carcinoma of the oral cavity, pharynx, or larynx diagnosed between 2001 and 2006 with a complete set of pretherapeutic laboratory values was identified. The influence of standard oncological parameters, comorbidity, and each laboratory value on overall survival (OS) was investigated in univariate and multivariate analyses.

RESULTS

Two-thirds of patients were active smokers and about one half reported high alcohol consumption. 40 % of patients had severe comorbidity according to Charlson comorbidity index. The most frequent laboratory pathologies were elevated C-reactive protein (CRP) values (66 %), impaired liver enzymes (30-50 %), decreased urea levels (33 %), leukocytosis (20 %), and anemia (10 %). In multivariate analysis for OS, a comorbidity index ≥5 (Hazard ratio [HR], 2.008; 95 % confidence interval [CI], 1.117-3.610; p = 0.020), high CRP level (HR, 2.469; CI, 1.414-4.310; p = 0.001), and abnormal low red-cell count (HR, 2.525; CI, 1.250-5.102; p = 0.010) were independent prognostic variables.

CONCLUSIONS

Comorbidity reflected by pathologic laboratory values is a major issue in HNC patients. Several pretherapeutic laboratory values have prognostic relevance for overall survival in HNC patients.