Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer

Linda X. Yin; David M. Routman; Courtney N. Day; William S. Harmsen; Travis Haller; Kathleen Bartemes; Daniel L. Price; Eric J. Moore; Robert L. Foote; Michelle Neben-Wittich; Ashish V. Chintakuntlawar; Daniel J. Ma; Katharine A. Price; Kathryn M. Van Abel

doi:10.1002/hed.27198

Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer

Linda X. Yin, David M. Routman, Courtney N. Day, William S. Harmsen, Travis Haller, Kathleen Bartemes, Daniel L. Price, Eric J. Moore, Robert L. Foote, Michelle Neben-Wittich, Ashish V. Chintakuntlawar, Daniel J. Ma, Katharine A. Price, Kathryn M. Van Abel

Research output: Contribution to journal › Article › peer-review

Abstract

Background: We aim to explore the prognostic role of absolute lymphocyte count (ALC) before, during, and after treatment on oncologic outcomes in human papillomavirus associated oropharyngeal cancer (HPV(+)OPSCC). Methods: Retrospective cohort at a tertiary center, 2006–2018. Multivariable Cox regressions were used to determine the effect of ALC on risk of progression. Univariate linear regression was performed to determine clinical factors associated with lower ALC. Results: All 197 patients underwent primary surgery. Mean (SD) ALC nadirs (×10⁹ cells/L) were: baseline (N = 149): 1.69 (0.56); postoperative (N = 126): 1.58 (0.59); post-RT (N = 141): 0.68 (0.35) and long-term (N = 105): 0.88 (0.37). Lower baseline ALC nadir was associated with worse overall survival (HR 3.85, 95%CI: 1.03–14.29, p = 0.04). Lower postoperative ALC nadir was associated with higher risk of progression (HR 2.63, 95%CI: 1.04–6.67, p = 0.04). Conclusions: Lower baseline ALC is associated with worse survival, whereas lower postoperative ALC is associated with increased risk of progression in surgically treated HPV(+)OPSCC. Level of Evidence: 3.

Original language	English (US)
Pages (from-to)	2760-2768
Number of pages	9
Journal	Head and Neck
Volume	44
Issue number	12
DOIs	https://doi.org/10.1002/hed.27198
State	Published - Dec 2022

Keywords

HPV
human papillomavirus
lymphocytes
lymphopenia
squamous cell

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.27198

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Yin, L. X., Routman, D. M., Day, C. N., Harmsen, W. S., Haller, T., Bartemes, K., Price, D. L., Moore, E. J., Foote, R. L., Neben-Wittich, M., Chintakuntlawar, A. V., Ma, D. J., Price, K. A., & Van Abel, K. M. (2022). Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer. Head and Neck, 44(12), 2760-2768. https://doi.org/10.1002/hed.27198

Yin, LX, Routman, DM, Day, CN, Harmsen, WS, Haller, T, Bartemes, K, Price, DL, Moore, EJ, Foote, RL, Neben-Wittich, M, Chintakuntlawar, AV, Ma, DJ, Price, KA & Van Abel, KM 2022, 'Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer', Head and Neck, vol. 44, no. 12, pp. 2760-2768. https://doi.org/10.1002/hed.27198

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title = "Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer",

abstract = "Background: We aim to explore the prognostic role of absolute lymphocyte count (ALC) before, during, and after treatment on oncologic outcomes in human papillomavirus associated oropharyngeal cancer (HPV(+)OPSCC). Methods: Retrospective cohort at a tertiary center, 2006–2018. Multivariable Cox regressions were used to determine the effect of ALC on risk of progression. Univariate linear regression was performed to determine clinical factors associated with lower ALC. Results: All 197 patients underwent primary surgery. Mean (SD) ALC nadirs (×109 cells/L) were: baseline (N = 149): 1.69 (0.56); postoperative (N = 126): 1.58 (0.59); post-RT (N = 141): 0.68 (0.35) and long-term (N = 105): 0.88 (0.37). Lower baseline ALC nadir was associated with worse overall survival (HR 3.85, 95%CI: 1.03–14.29, p = 0.04). Lower postoperative ALC nadir was associated with higher risk of progression (HR 2.63, 95%CI: 1.04–6.67, p = 0.04). Conclusions: Lower baseline ALC is associated with worse survival, whereas lower postoperative ALC is associated with increased risk of progression in surgically treated HPV(+)OPSCC. Level of Evidence: 3.",

keywords = "HPV, human papillomavirus, lymphocytes, lymphopenia, squamous cell",

author = "Yin, {Linda X.} and Routman, {David M.} and Day, {Courtney N.} and Harmsen, {William S.} and Travis Haller and Kathleen Bartemes and Price, {Daniel L.} and Moore, {Eric J.} and Foote, {Robert L.} and Michelle Neben-Wittich and Chintakuntlawar, {Ashish V.} and Ma, {Daniel J.} and Price, {Katharine A.} and {Van Abel}, {Kathryn M.}",

note = "Publisher Copyright: {\textcopyright} 2022 Wiley Periodicals LLC.",

year = "2022",

month = dec,

doi = "10.1002/hed.27198",

language = "English (US)",

volume = "44",

pages = "2760--2768",

journal = "Head and Neck",

issn = "1043-3074",

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TY - JOUR

T1 - Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer

AU - Yin, Linda X.

AU - Routman, David M.

AU - Day, Courtney N.

AU - Harmsen, William S.

AU - Haller, Travis

AU - Bartemes, Kathleen

AU - Price, Daniel L.

AU - Moore, Eric J.

AU - Foote, Robert L.

AU - Neben-Wittich, Michelle

AU - Chintakuntlawar, Ashish V.

AU - Ma, Daniel J.

AU - Price, Katharine A.

AU - Van Abel, Kathryn M.

PY - 2022/12

Y1 - 2022/12

N2 - Background: We aim to explore the prognostic role of absolute lymphocyte count (ALC) before, during, and after treatment on oncologic outcomes in human papillomavirus associated oropharyngeal cancer (HPV(+)OPSCC). Methods: Retrospective cohort at a tertiary center, 2006–2018. Multivariable Cox regressions were used to determine the effect of ALC on risk of progression. Univariate linear regression was performed to determine clinical factors associated with lower ALC. Results: All 197 patients underwent primary surgery. Mean (SD) ALC nadirs (×109 cells/L) were: baseline (N = 149): 1.69 (0.56); postoperative (N = 126): 1.58 (0.59); post-RT (N = 141): 0.68 (0.35) and long-term (N = 105): 0.88 (0.37). Lower baseline ALC nadir was associated with worse overall survival (HR 3.85, 95%CI: 1.03–14.29, p = 0.04). Lower postoperative ALC nadir was associated with higher risk of progression (HR 2.63, 95%CI: 1.04–6.67, p = 0.04). Conclusions: Lower baseline ALC is associated with worse survival, whereas lower postoperative ALC is associated with increased risk of progression in surgically treated HPV(+)OPSCC. Level of Evidence: 3.

AB - Background: We aim to explore the prognostic role of absolute lymphocyte count (ALC) before, during, and after treatment on oncologic outcomes in human papillomavirus associated oropharyngeal cancer (HPV(+)OPSCC). Methods: Retrospective cohort at a tertiary center, 2006–2018. Multivariable Cox regressions were used to determine the effect of ALC on risk of progression. Univariate linear regression was performed to determine clinical factors associated with lower ALC. Results: All 197 patients underwent primary surgery. Mean (SD) ALC nadirs (×109 cells/L) were: baseline (N = 149): 1.69 (0.56); postoperative (N = 126): 1.58 (0.59); post-RT (N = 141): 0.68 (0.35) and long-term (N = 105): 0.88 (0.37). Lower baseline ALC nadir was associated with worse overall survival (HR 3.85, 95%CI: 1.03–14.29, p = 0.04). Lower postoperative ALC nadir was associated with higher risk of progression (HR 2.63, 95%CI: 1.04–6.67, p = 0.04). Conclusions: Lower baseline ALC is associated with worse survival, whereas lower postoperative ALC is associated with increased risk of progression in surgically treated HPV(+)OPSCC. Level of Evidence: 3.

KW - HPV

KW - human papillomavirus

KW - lymphocytes

KW - lymphopenia

KW - squamous cell

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U2 - 10.1002/hed.27198

DO - 10.1002/hed.27198

M3 - Article

C2 - 36129387

AN - SCOPUS:85138427194

SN - 1043-3074

VL - 44

SP - 2760

EP - 2768

JO - Head and Neck

JF - Head and Neck

IS - 12

ER -

Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer

Abstract

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