Prognostic significance of the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and panimmune-inflammation value (PIV) in head and neck squamous cell carcinoma (HNSCC): A retrospective cohort study.

ObjectiveInflammatory markers, such as the neutrophil-to-lymphocyte Ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and panimmune-inflammatory value (PIV), have previously been identified as prognostic factors in head and neck cancer (HNC). Notably, time-dependent receiver operating characteristic (ROC) curves have rarely been used to assess the prognostic role of inflammatory markers in head and neck cancer. This study aimed to evaluate the significance of the NLR, SII, SIRI, and PIV in this context.MethodsThis retrospective cohort study was conducted at Far Eastern Memorial Hospital, a tertiary medical center between July 2022 and January 2025, and 153 patients with HNC were enrolled in this study. Inflammatory markers were compared by tumor status, nodal involvement, and stage. Time-dependent ROC analysis was used to determine the area under the curve (AUC) and optimal cutoff values for overall survival (OS) and disease-specific survival (DSS) with Cox regression.ResultsThe NLR, SII, SIRI, and PIV were significantly associated with tumor status and stage (p < 0.05). The optimal cutoff values were 2.9, 630, 1.6, and 400, with corresponding time-dependent AUCs of 0.73, 0.71, 0.64, and 0.62, with corresponding sensitivities of 81.7%, 81.2%, 55.9%, and 60.8%, and specificities of 64.1%, 54.9%, 68.5%, and 60.4%., respectively. Higher NLR, SII, SIRI, and PIV values were associated with poor OS and DSS.ConclusionsThe NLR, SII, SIRI, and PIV are associated with tumor status and poor survival outcomes (OS and DSS) and may provide additional stratification and risk-based management in patients with HNC.