Background:
The H-index was recently developed and quantified the prognostic capacity of host characteristics associated with oral squamous cell carcinomas. The H-index included pre-treatment levels of neutrophils, lymphocytes, albumin, haemoglobin and monocytes. However, the applicability of the H-index to other head and neck subsites is yet to be determined. Therefore, we aimed to study the association between the host-index score and Oropharyngeal cancer.
Objective
To assess the applicability and the prognostic role of the H-index in patients with Oropharyngeal squamous cell carcinomas
Design and Method:
Retrospective institutional database analysis in a South Australian tertiary centre
Data was collected retrospectively from departmental databases and medical records. Oropharyngeal squamous cell carcinomas cases treated with curative intent (January 2012 to December 2018), with a median follow up time of 37 months were analysed. Serum tests conducted within 4 weeks of commencing treatment were collated and H-index score calculated as described by Valero et al [1]. A stepwise binomial logistic regression model was generated to assess the H-index score and treatment failure. Classification tables were used to calculate sensitivity, specificity, positive and negative predictive values.
Results
104 patients (91 males [87.5%], mean age 58 [SD 0.1]) were analysed. The tonsil was the most common subsite (59%) and 80.6% of cases were p16 positive. Chemoradiotherapy was the most common treatment (61%) modality. Treatment failure occurred for 28 patients (27%) (progression of disease during treatment, residual disease at 3 months or post-treatment recurrence). Through logistic regression, the H-index score was predictive of treatment failure (p=0.041), with a positive predictive value of 83%.
Summary and conclusion
These findings demonstrate the potential prognostic role of the H-index score to predict treatment failure in oropharyngeal squamous cell carcinoma. However, further research with an increased sample size consisting of a larger group of cases that failed treatment is required to appropriately validate this test.