Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer

• Published in: The Laryngoscope 2021-03, Vol.131 (3), p.E836-E845
• Main Authors: Borsetto, Daniele, Polesel, Jerry, Tirelli, Giancarlo, Menegaldo, Anna, Baggio, Vittorio, Gava, Alessandro, Nankivell, Paul, Pracy, Paul, Fussey, Jonathan, Boscolo‐Rizzo, Paolo
• Format: Article
• Language: English
• Subjects: Aged; anemia; Chemoradiotherapy; Erythrocyte Indices; Female; Head and Neck Neoplasms - blood; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - therapy; Head and neck squamous cell carcinoma; Hemoglobins - metabolism; HPV; Humans; Male; Mean corpuscular volume; Middle Aged; Neoplasm Staging; Platelet Count; platelets; Prognosis; Proportional Hazards Models; Retrospective Studies; Serum Albumin - metabolism; Squamous Cell Carcinoma of Head and Neck - blood; Squamous Cell Carcinoma of Head and Neck - mortality; Squamous Cell Carcinoma of Head and Neck - therapy; Survival Rate
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.28882

Objective Mean corpuscular volume (MCV) has been shown in to be a reliable prognostic marker in other cancers; however, no evidence exists on its use in head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the association between MCV, hemoglobin, platelet count and albumin concentration, and survival in stage III/IVA‐B HNSCC treated with concurrent chemoradiotherapy. Study Design Retrospective cohort study. Methods In this multicenter retrospective study, we analyzed MCV, platelet count, hemoglobin concentration, and albumin concentration in peripheral blood samples from 260 patients with HNSCC undergoing organ preservation treatment with curative intent at the time of diagnosis. We then analyzed survival outcomes after accounting for confounders using multivariate analysis. Results After adjustment for potential confounders, patients with low hemoglobin had a 3.3‐fold higher risk of death (95% confidence interval [CI]: 2.26‐4.81) than those with normal hemoglobin. Patients with an elevated MCV had a 1.54‐fold higher risk of death (95% CI: 1.06‐2.24), independent of site, stage, and human papillomavirus status. Interestingly, the effect of MCV on overall and progression‐free survival was limited to those with a normal pretreatment hemoglobin. We identified no associations between pretreatment platelet count or albumin concentration and survival. Conclusion These findings suggest that pretreatment anemia and macrocytosis are independent predictors of lower overall and progression‐free survival in HNSCC patients undergoing organ preservation treatment. Level of Evidence III Laryngoscope, 131:E836–E843, 2021