Abstract
ABSTRACT
Objectives
To investigate the prognostic value of the systemic inflammation‐related biomarkers of neutrophil‐lymphocyte, albumin‐globulin, lymphocyte‐monocyte, and platelet‐lymphocyte ratios at three perioperative time points, and to explore their association with clinicopathologic features and disease‐specific survival.
Methods
In 220 oral squamous cell carcinoma patients undergoing surgery (2012–2023), we assessed risk factors, such as extranodal extension, TNM stage, and biomarker cutoffs (neutrophil‐lymphocyte 5.0; albumin‐globulin 1.21; lymphocyte‐monocyte 3.14; platelet‐lymphocyte 218.9). Disease‐specific survival was analyzed using Kaplan–Meier curves, log‐rank tests, and Cox multivariate models. Significance set at
p
Results
Biomarkers measured 3 months postoperatively were the strongest predictors. Multivariate analysis identified high neutrophil‐lymphocyte (HR = 2.99, 95% CI 1.44–6.21;
p
= 0.003), low albumin‐globulin (HR = 0.44, 95% CI 0.21–0.89;
p
= 0.023) ratios, and extranodal extension (HR = 3.17, 95% CI 1.54–6.52;
p
= 0.002) as independent predictors of poorer disease‐specific survival. Importantly, neutrophil‐lymphocyte prognostic impact was comparable to that of extranodal extension, a well‐established pathological risk factor.
Conclusions
Three months post‐surgery, high neutrophil‐lymphocyte and low albumin‐globulin ratios independently predict worse disease‐specific survival in oral cancer. Neutrophil‐lymphocyte, a simple and widely available biomarker, offers prognostic insight comparable to extranodal extension, supporting its integration into postoperative risk stratification and potentially guiding adjuvant therapy decisions.