{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:54:16Z","timestamp":1782896056249,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004738","name":"E-Da Hospital","doi-asserted-by":"publisher","award":["EDAHP107059"],"award-info":[{"award-number":["EDAHP107059"]}],"id":[{"id":"10.13039\/501100004738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004738","name":"E-Da Hospital","doi-asserted-by":"publisher","award":["EDAHS111018"],"award-info":[{"award-number":["EDAHS111018"]}],"id":[{"id":"10.13039\/501100004738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["MOHW111\u2010TDU\u2010B\u2010221\u2010114006"],"award-info":[{"award-number":["MOHW111\u2010TDU\u2010B\u2010221\u2010114006"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["MOST\u2010110\u20102314\u2010B\u2010650\u2010003"],"award-info":[{"award-number":["MOST\u2010110\u20102314\u2010B\u2010650\u2010003"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with head and neck squamous cell carcinoma (HNSCC) frequently develop synchronous esophageal cancer (ESCC), but there is a lack of clinical predictors. The neutrophil to lymphocyte (NLR), platelet to lymphocyte (PLR), and lymphocyte to monocyte ratios (LMRs), reflect the balance between pro\u2010cancer inflammation and anti\u2010cancer immune responses, but their role in HNSCC and synchronous cancer remain uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study consecutively enrolled a total of 717 patients with newly diagnosed HNSCC who received pre\u2010treatment esophageal endoscopic screening. The pretreatment NLR, LMR and PLRs were calculated and analyzed in comparison with the clinical factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 103 patients (14.4%) were found to have synchronous ESCCs, and were associated with a significantly lower absolute lymphocyte count (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), higher NLRs (<jats:italic>p<\/jats:italic>\u2009=\u20090.044) and lower LMRs (<jats:italic>p<\/jats:italic>\u2009=\u20090.001), but not PLRs (<jats:italic>p<\/jats:italic>\u2009=\u20090.49). The ROC curve for the presence of synchronous ESCC verified the optimal cutoff value as 2.5 for NLRs and 4.0 for LMRs. Multivariable logistic regression revealed that a LMR\u2009&lt;4 (OR 2.22; 95% CI 1.27\u20133.88, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), alcohol consumption (OR 4.19; 95% CI 1.47\u201311.91, <jats:italic>p<\/jats:italic>\u2009=\u20090.007), tumor location over the pharynx (OR 1.68; 95% CI 1.07\u20132.64, <jats:italic>p<\/jats:italic>\u2009=\u20090.025), and low body mass index (OR 0.94; 95% CI 0.88\u20130.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.039) were risk factors for developing synchronous ESCC. A low\u2010LMR was significantly associated with decreases in overall survival (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), in both synchronous and non\u2010synchronous groups. Multivariate analysis demonstrated that LMR\u2009&lt;4 (HR 1.97; 95% CI 1.38\u20132.81, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), a low\u2010BMI (HR 0.96; 95% CI 0.93\u20130.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.044) and presence of synchronous ESCC (HR 1.56; 95% CI 1.10\u20132.22, <jats:italic>p<\/jats:italic>\u2009=\u20090.013) were independent prognostic factors for HNSCC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Incorporation of LMR into other identified risk factors, such as alcohol consumption, tumor location over pharynx, and low\u2010BMI, may establish a more efficient screening program for esophageal exploration in HNSCC patients. The significances of LMR also suggest that anti\u2010cancer immunity may play a role in the filed cancerization to initiate multiple cancers, and the immunotherapy may have potentials for prevention or as an adjuvant treatment for synchronous SCC in the future.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27677","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T10:35:33Z","timestamp":1707734133000},"page":"1946-1955","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prognostic significances of systemic inflammatory response markers in patients with synchronous esophageal and head and neck cancers"],"prefix":"10.1002","volume":"46","author":[{"given":"Chih\u2010Chun","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology E\u2010Da Hospital\/I\u2010Shou University  Kaohsiung 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