Real-World Outcomes of Treatment Approaches and the Impact of Systemic Inflammation Markers on Survival in Patients with Locally Advanced and Metastatic Laryngeal Cancer

<b>Background:</b> Systemic inflammation and nutritional status have emerged as promising prognostic indicators across various malignancies; however, their clinical relevance in advanced laryngeal cancer remains underexplored. This study aimed to evaluate the prognostic significance of inflammation- and nutrition-based indices on the overall survival (OS) and progression-free survival (PFS) in patients with locally advanced or metastatic laryngeal cancer. <b>Methods:</b> A total of 147 patients treated at Pamukkale University between 2013 and 2022 were retrospectively analyzed. Baseline hematologic and biochemical parameters were used to calculate the Naples Prognostic Score (NPS), the Controlling Nutritional Status (CONUT) score, the Systemic Immune-Inflammation Index (SII), the Systemic Inflammation Response Index (SIRI), the C-reactive Protein/Albumin Ratio (CAR), and the Prognostic Nutritional Index (PNI). Survival outcomes were estimated using the Kaplan-Meier method, and independent prognostic factors were identified by Cox regression analyses. <b>Results:</b> The median OS and PFS were 55.5 and 48.8 months, respectively. In univariate analyses, high NPS, CONUT, SIRI, SII, and CAR values were significantly associated with inferior OS and PFS (<i>p</i> < 0.05). Multivariate analyses identified advanced stage, disease progression during chemotherapy, and high NPS as independent predictors of both the OS and PFS, whereas surgery conferred a survival advantage. <b>Conclusions:</b> Inflammation- and nutrition-based indices, particularly NPS, are strong prognostic markers for survival in patients with advanced laryngeal cancer. Routine integration of these parameters may enhance individualized risk stratification and guide treatment decisions in clinical practice.