Evidence map›Paper›PMID 40491270›Full record

ArticleHead & neck2025

Pretreatment Neutrophil-to-Lymphocyte Ratio (NLR) Predicts Treatment Toxicity and Intolerance in Operable Head and Neck Cancer: An Ambispective Cohort Study.

Raisa Chowdhury, Karim Botros, Keith Richardson, Alex M Mlynarek, Nader Sadeghi, Michael P Hier, Sabrina Wurzba, Khashayar Esfahani, Nathaniel Bouganim, Khalil Sultanem and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Head & neck, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Raisa ChowdhuryFaculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.ORCID 0009-0000-5433-5808
Karim BotrosDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.ORCID 0009-0009-1193-8831
Keith RichardsonDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Alex M MlynarekDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Nader SadeghiDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Michael P HierDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Sabrina WurzbaDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Khashayar EsfahaniDepartment of Medical Oncology, McGill University, Montreal, Quebec, Canada.
Nathaniel BouganimDepartment of Medical Oncology, McGill University, Montreal, Quebec, Canada.
Khalil SultanemDepartment of Radiation Oncology, McGill University, Montreal, Quebec, Canada.
George ShenoudaDepartment of Radiation Oncology, McGill University, Montreal, Quebec, Canada.
Christina TsienDepartment of Radiation Oncology, McGill University, Montreal, Quebec, Canada.
Marco A MascarellaDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPretreatment neutrophil to lymphocyte ratio (NLR) is a negative prognostic marker for survival in head and neck cancer (HNC). Its association with treatment toxicity and intolerance in patients undergoing curative-intent surgery is unknown.

methodsAmbispective study of patients with operable stage II-IV, HPV-negative HNC treated at two academic hospitals. Multiple logistic regression was performed to evaluate the association between pretreatment NLR and short-term treatment outcomes including treatment toxicity and intolerance.

resultsAmong 456 patients, 194 experienced treatment-related toxicity, defined as grade ≥ 3 adverse events, and 200 exhibited treatment intolerance, defined as treatment discontinuation or delay due to poor tolerance. High pretreatment NLR was significantly associated with an increased risk of toxicity (OR 1.04; 95% CI: 1.00-1.09) and intolerance (OR 1.06; 95% CI: 1.01-1.12). Patients with an NLR < 2.5 had significantly lower odds of experiencing toxicity (OR 0.50; 95% CI: 0.26-0.96) and intolerance (OR 0.57; 95% CI: 0.33-0.99) after adjusting for multiple confounders.

conclusionsLow pretreatment NLR was associated with reduced treatment toxicity and lower rates of intolerance in patients undergoing curative-intent surgery for HNC.

Indexed as

Head and Neck NeoplasmsLymphocytesNeutrophilsAdultAgedCohort StudiesFemaleHumansLeukocyte CountLogistic ModelsLymphocyte CountMaleMiddle AgedNeoplasm StagingPrognosisRetrospective Studieshead and neck cancerneutrophil‐to‐lymphocyte ratio (NLR)prognostic biomarkertreatment intolerancetreatment toxicity

Identifiers

PMID40491270
PMCPMC12541678

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.