Inflammatory Markers‐Based Surgical Pathological Complete Response Prediction After Neoadjuvant Immunotherapy Combined With Chemotherapy in Head and Neck Squamous Cell Carcinoma

ABSTRACT Objective To explore the predictive value of blood routine parameters for surgical pathological complete response (PCR) following neoadjuvant immunotherapy combined with chemotherapy (NICC) in patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC). Methods We retrospectively analyzed patients with LAHNSCC who underwent NICC and the subsequent surgery at our hospital between May 2021 and November 2024. PCR included PCR of the primary tumor site (PPCR), PCR of the metastatic lymph node (LPCR), and PCR of both the primary tumor site and metastatic lymph node (PLPCR). Results Of the 109 patients assessed, 41 (37.6%) achieved PPCR and 57 (52.3%) achieved LPCR. Of these, 29(26.6%) patients achieved PLPCR. LPCR did not exhibit any significant associations with the clinical parameters ( p > 0.05). However, higher PPCR was significantly associated with the neutrophils‐to‐lymphocyte ratio (NLR) ≤ 2.115 (72.7% vs. 13.8%, odds ratio 18.672, 95% confidence interval 4.261–81.827, p < 0.001) Furthermore, patients with NLR ≤ 2.115 showed a significantly independent predictive factor for higher PLPCR (50.0% vs. 10.8%, p = 0.014). Conclusions NLR may serve as valuable predictors of PCR following NICC in LAHNSCC. Specifically, patients with NLR ≤ 2.115 may have a higher likelihood of achieving PPCR and PLPCR.