Evaluation of the Naples Prognostic Score in Patients with Head and Neck Squamous Cell Carcinoma

BACKGROUND/OBJECTIVES: Systemic inflammation and nutritional status are two factors known to influence the prognosis of cancer patients. The Naples Prognostic Score (NPS) includes two inflammatory and two nutritional markers and combines them in a single score to better predict survival of cancer patients. In this study, we aimed to critically evaluate the NPS for its significance in head and neck cancer patients. METHODS: We retrospectively analyzed the preoperative NPS and its association with overall survival (OS) and disease-free survival (DFS). We evaluated 140 patients with head and neck squamous cell carcinoma (HNSCC) who were treated with primary surgical therapy at a tertiary center between 2001 and 2019. OS and DFS were analyzed using Kaplan-Meier estimators, the log-rank test and uni- and multivariable Cox models. RESULTS: The median postoperative follow-up was 6.7 years. Higher NPS showed numerically, but not significantly shorter OS and DFS. Sensitivity analysis for all markers included in the NPS revealed only the neutrophil-to-lymphocyte ratio (NLR) as a significant predictor for OS and DFS. CONCLUSIONS: These findings suggest that the overall NPS may have limited prognostic value in this cohort. In contrast, NLR appears to be a more robust and clinically relevant marker for survival outcomes in patients with head and neck squamous cell carcinoma.