Neutrophil-to-lymphocyte ratio (NLR) may be a strong predictor of overall survival in oral, pharyngeal, and laryngeal squamous cell carcinomas, according to a recent study published online in the journal Head & Neck.1

Researchers led by Saleh Rachidi, BS, of the Medical University of South Carolina in Charleston conducted a retrospective study of pretreatment neutrophil and lymphocyte counts as well as NLR in correlation with overall survival in patients with head and neck cancer.

“Current prognostic criteria are insufficient in predicting outcomes in head and neck cancer, necessitating new, readily available biomarkers,” the authors noted.

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They found that patients in the highest tertile of neutrophil count as well as those in the lowest tertile of lymphocyte count were associated with shorter survival than the rest of the examined population.

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Upon multivariate analysis, those in the highest tertile of NLR were found to be at a higher risk compared to those in the lowest tertile.

In addition, NLR was found to be lower among patients with human papillomavirus (HPV)-positive tumors compared to those with HPV-negative tumors, and it was also predictive of survival in both types.


  1. Rachidi S, Wallace K, Wrangle JM, et al. Neutrophil-to-lymphocyte ratio and overall survival in all sites of head and neck squamous cell carcinoma. Head Neck. [published online ahead of print September 28, 2015]. DOI: 10.1002/hed.24159.