The Applicability of Neutrophil-Lymphocyte Ratio in Predicting The Survival of Nasopharyngeal Cancer: An Evidence Based Case Report

Abstract

smutya12@yahoo.com Background.. Nasopharyngeal cancer (NPC) is still a huge burden especially in distinct parts of the world where it has high prevalence and mortality. There are several prognostic factors in NPC, however additional marker is needed to give a better picture on disease outcome. Innate and adaptive immunity play a great role in disease progression; however, the role of neutrophil-lymphocyte ratio (NLR) is still controversial. This study aimed to investigate the role of NLR status as a prognostic factor in NPC. Methods. Literature search was conducted through PubMed, Cochrane, ProQuest, EBSCO and Science Direct following specific keywords. Duplicates were filtered out and remaining articles were screened based on the eligibility criteria before critical appraisal and measurement of level of evidence by The Centre for Evidence-Based Medicine (CEBM) University of Oxford. Review for the best available evidence was done by two-independent reviewer. Result. : 130 records were retrieved and 6 final articles were selected for final appraisal. All studies were published after 2017 with sample sizes ranging from 140 to 5973 subjects. NLR cut-offs varied across studies (2.21-3.6) and the overall survival (OS) ranging from 51-82.5%. Moreover, 5-year disease specific survival (DSS) and progression free survival (PFS) for low and high NLR were 76-90.5% vs 53-82.1% and 68-86.2% vs 52-76.5%, respectively. Conclusion. NLR status can be used to predict OS in NPC patients. A careful approach should be taken in determining treatment options. Further research is needed to understand the role of NLR in combination with other biomarker to predict the survival of NPC patients.