Preoperative Inflammatory Blood Biomarkers in Sinonasal Carcinoma: A Scoping Review

Background and Objectives: Sinonasal carcinomas are heterogeneous malignancies often associated with poor prognosis because of the locally advanced stage at presentation and high recurrence rates. Easily accessible prognostic biomarkers are therefore of increasing clinical interest. Systemic inflammatory blood markers have shown prognostic value in several solid tumors, but their role in sinonasal carcinomas remains unclear. Materials and Methods: A scoping review was performed according to PRISMA-ScR recommendations. The PubMed/MEDLINE, Scopus, and Embase databases were searched from inception to March 2026. Original English-language studies evaluating preoperative or pre-treatment inflammatory blood biomarkers in sinonasal malignant tumors were included. Results: Six retrospective single-center studies met the inclusion criteria, comprising 1049 patients. All studies evaluated biomarkers before treatment initiation in cohorts managed primarily with upfront surgery. The neutrophil-to-lymphocyte ratio (NLR) was the most frequently investigated biomarker and the one most commonly associated with adverse oncologic outcomes, including poorer survival, advanced stage, and increased recurrence risk. Additional biomarkers included the platelet-to-lymphocyte ratio, advanced lung cancer inflammation index (ALI), systemic immune-inflammation index (SII), and other composite scores. Preliminary evidence suggests that ALI and SII may provide additional prognostic information beyond isolated inflammatory ratios, although current evidence remains limited. Conclusions: Preoperative inflammatory blood biomarkers, particularly NLR, appear to be promising, low-cost, and widely accessible prognostic tools for risk stratification in sinonasal carcinomas. However, current evidence is limited by retrospective study design, heterogeneous cohorts, and non-standardized cut-off values. Prospective multicenter studies are needed before routine clinical implementation can be recommended.