Evidence map›Paper›PMID 41838159›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Systemic inflammation plays a key prognostic role in patients with head and neck cancer treated with immunotherapy and is linked to CT-based body composition metrics.

Frederic Jungbauer, Sonja Ludwig, Lena Huber, Annette Affolter, Anne Lammert, Nicole Rotter, Claudia Scherl, Elena Seiz, Farroch Vahidi Noghani, Stefan O Schönberg and 3 more

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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.

Frederic JungbauerDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Sonja LudwigDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Lena HuberDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Annette AffolterDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Anne LammertDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Nicole RotterDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Claudia ScherlDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Elena SeizDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Farroch Vahidi NoghaniDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Stefan O SchönbergDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Johannes HauboldDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, 45147, Germany.
Clara ArndtDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, 68167, Germany.
Johannes M LudwigDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. Johannes.ludwig@umm.de.ORCID http://orcid.org/0000-0003-0838-8831

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate the prognostic significance of pretreatment inflammatory markers and their association with computed tomography (CT)-based body composition (BC) metrics in patients with recurrent and/or metastatic head and neck squamous cell cancer (HNSCC) treated with immunotherapy.

methodsThis retrospective, single-center study included 49 patients with HNSCC (20.4% female; median age 66 years). Eleven inflammatory markers, including the systemic-inflammatory-response-index (SIRI=(neutrophils×monocytes)/lymphocytes), derived neutrophil-to-lymphocyte ratio (dNLR=neutrophils/(leukocytes–neutrophils) were investigated. Pretreatment thoracic CTs yielded volumes of skeletal muscle (SM), visceral adipose tissue (VAT), and bone (B). Overall survival (OS) was assessed using Kaplan-Meier and Cox regression (HR: Hazard Ratio); group comparisons: Pearson’s and Mann-Whitney U.

resultsThe median OS was 17.6 months. A significantly lower HR was observed in males with positive p16-status, lower ECOG, and albumin > 3.4 g/dl. Regarding inflammation, low SIRI demonstrated the strongest HR of all inflammatory markers. In multivariate analysis, low SIRI (HR: 0.17, 95% CI: 0.05–0.57, p = 0.0041) and low albumin (HR: 0.26, 95%CI: 0.10–0.66, p = 0.0047) were identified as independent prognostic factors. Correlation analysis revealed a weak association between dNLR and neutrophil/leukocyte counts with SM/B (r=-0.39 and − 0.47) and (SM + VAT)/B (r = -0.36, -0.47) (p ≤ 0.02). Patients with low dNLR had higher SM/B (1.77 vs. 1.35) and (SM + VAT)/B (2.05 vs. 1.54) ratios than those with high dNLR (p < 0.0001).

conclusionsPretreatment SIRI and serum albumin levels are strong, independent prognostic markers for survival in HNSCC patients receiving immunotherapy. While a link between systemic inflammation, mainly driven by neutrophils, and BC-parameters has been observed, its clinical relevance warrants further investigation.

Indexed as

Body CompositionHead and Neck NeoplasmsImmunotherapyInflammationSquamous Cell Carcinoma of Head and NeckAgedAged, 80 and overFemaleHumansLymphocytesMaleMiddle AgedNeutrophilsPrognosisRetrospective StudiesTomography, X-Ray ComputedAISI (Index of Systemic Inflammation)AlbuminBody Composition Analysis (BCA)Computed Tomography (CT) ImagingCRP (C-Reactive Protein)CRP/L (C-Reactive Protein to Lymphocyte Ratio)dNLR (derived Neutrophil to Lymphocyte Ratio)Head and Neck Squamous Cell Cancer (HNSCC)ImmunotherapyLMR (Lymphocyte to Monocyte Ratio)NER (Neutrophil to Eosinophil Ratio)NLPR (Neutrophil to Lymphocyte Platelet Ratio)NLR (Neutrophil to Lymphocyte Ratio)PLR (Platelet to Lymphocyte Ratio)SII (Systemic Inflammatory Index)SIRI (Systemic Inflammatory Response Index)

Identifiers

PMID41838159
PMCPMC13152974

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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.