Agus Fitriyanto Achmad, Johan Kurnianda, Susanna Hilda Hutajulu
Background: Prognostic markers for Nasopharyngeal Carcinoma (NPC) are still urgently needed but current marker of Epstein-Barr virus DNA require high costs and technical requirements limit applications in patient care. Inflammatory cells play an important role in the development of a cancer and it has been shown in various solid tumors that inflammatory cells influence the patient's prognosis. COP-NLR score peripheral blood are easily obtained and can also reflect host inflammatory responses.
Objective: To assess peripheral blood COP-NLR score before therapy as a prognostic marker in NPC patients. Methods: A retrospective cohort study using data from the clinical registry of NPC patients diagnosed from 2007-2016 at Dr. Sardjito Hospital Yogyakarta. Survival analysis with the Kaplan-Meier curve and Cox regression was used to examine the influence of patient factors (age, sex and nutritional status), tumor factors (tumor size, node), therapeutic factors (type of therapy), clinical factors (anemia ) and COP-NLR score for overall survival of stage III-IVB NPC patients.
Result: A total of 358 stage III-IVB NPC patients were analyzed in this study. Determination of COP-NLR score using the NLR limit of 4.28 and the number of tombocytes 496 × 103 / uL. If NLR ≤ 4.28 and platelet count ≤ 496 × 103 / uL, the score is 0. If NLR> 4.28 or platelet count> 496 ×103 / uL, the score is 1. If NLR> 4.28 and platelet count> 496 ×103 / uL, the score is 2. Two-year overall survival of patients with a score of 0, 1, 2 was 72.2%, 57.3%, and 41.4% (p=0.002). A higher COP-NLR score (1&2) showed a decrease in the 2-year overall survival rate than lower score (0) with HR 1.887 (95% CI : 1.26-2.81 and p=0.002).
Conclusion: Stage III-IVB NPC patients with COP-NLR score 0 before therapy have a better 2 years overall survival rate than patients with COPNLR scores 1 and 2.