{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:54:16Z","timestamp":1791269656479,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the prognostic value of the systemic inflammation\u2010related biomarkers of neutrophil\u2010lymphocyte, albumin\u2010globulin, lymphocyte\u2010monocyte, and platelet\u2010lymphocyte ratios at three perioperative time points, and to explore their association with clinicopathologic features and disease\u2010specific survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In 220 oral squamous cell carcinoma patients undergoing surgery (2012\u20132023), we assessed risk factors, such as extranodal extension, TNM stage, and biomarker cutoffs (neutrophil\u2010lymphocyte 5.0; albumin\u2010globulin 1.21; lymphocyte\u2010monocyte 3.14; platelet\u2010lymphocyte 218.9). Disease\u2010specific survival was analyzed using Kaplan\u2013Meier curves, log\u2010rank tests, and Cox multivariate models. Significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Biomarkers measured 3 months postoperatively were the strongest predictors. Multivariate analysis identified high neutrophil\u2010lymphocyte (HR\u2009=\u20092.99, 95% CI 1.44\u20136.21;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), low albumin\u2010globulin (HR\u2009=\u20090.44, 95% CI 0.21\u20130.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) ratios, and extranodal extension (HR\u2009=\u20093.17, 95% CI 1.54\u20136.52;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) as independent predictors of poorer disease\u2010specific survival. Importantly, neutrophil\u2010lymphocyte prognostic impact was comparable to that of extranodal extension, a well\u2010established pathological risk factor.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Three months post\u2010surgery, high neutrophil\u2010lymphocyte and low albumin\u2010globulin ratios independently predict worse disease\u2010specific survival in oral cancer. Neutrophil\u2010lymphocyte, a simple and widely available biomarker, offers prognostic insight comparable to extranodal extension, supporting its integration into postoperative risk stratification and potentially guiding adjuvant therapy decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70515","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:35:06Z","timestamp":1791268506000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Inflammatory Ratios Predict Survival in Oral Squamous Cell Carcinoma"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9271-5668","authenticated-orcid":false,"given":"Idan","family":"Gavrielov","sequence":"first","affiliation":[{"name":"School of Dentistry Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1269-1630","authenticated-orcid":false,"given":"Alex","family":"Dobriyan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idan","family":"Shavit","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1187-2333","authenticated-orcid":false,"given":"Marilena","family":"Vered","sequence":"additional","affiliation":[{"name":"Institute of Pathology Sheba Medical Center  Ramat Gan Israel"},{"name":"Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dentistry Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"7","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers12071986","article-title":"Hypoalbuminemia Reflects Nutritional Risk, Body Composition and Systemic Inflammation and Is Independently Associated With Survival in Patients With Colorectal Cancer","volume":"12","author":"Almasaudi A. 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J.","year":"2022","journal-title":"Journal of the National Comprehensive Cancer Network"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.oraloncology.2021.105451","article-title":"Overview of Oral Cavity Squamous Cell Carcinoma: Risk Factors, Mechanisms, and Diagnostics","volume":"121","author":"Chamoli A.","year":"2021","journal-title":"Oral Oncology"},{"issue":"29","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"3269","DOI":"10.1200\/JCO.2015.61.2929","article-title":"Oral Cavity Carcinoma: Current Management, Controversies, and Future Directions","volume":"33","author":"Chinn S. B.","year":"2015","journal-title":"Journal of Clinical Oncology"},{"issue":"8","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"3446","DOI":"10.1172\/JCI67484","article-title":"Neutrophil Extracellular Traps Sequester Circulating Tumor Cells and Promote Metastasis","volume":"123","author":"Cools\u2010Lartigue J.","year":"2013","journal-title":"Journal of Clinical Investigation"},{"issue":"1","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-024-04690-z","article-title":"Comprehensive Survival Analysis of Oral Squamous Cell Carcinoma Patients Undergoing Initial Radical Surgery","volume":"24","author":"Dong L.","year":"2024","journal-title":"BMC Oral Health"},{"issue":"9","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.oraloncology.2013.07.003","article-title":"Inflammation in the Context of Oral Cancer","volume":"49","author":"Feller L.","year":"2013","journal-title":"Oral Oncology"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1038\/nrc3245","article-title":"The Immune Contexture in Human Tumours: Impact on Clinical Outcome","volume":"12","author":"Fridman W. 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Cancer"},{"issue":"10","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1001\/jamaoncol.2023.2960","article-title":"The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019","volume":"9","author":"GBD 2019 Lip, Oral, and Pharyngeal Cancer Collaborators","year":"2023","journal-title":"JAMA Oncology"},{"issue":"1","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.3177\/jnsv.53.37","article-title":"Relationship Between Serum Albumin Level and Aging in Community\u2010Dwelling Self\u2010Supported Elderly Population","volume":"53","author":"Gom I.","year":"2007","journal-title":"Journal of Nutritional Science and Vitaminology (Tokyo)"},{"issue":"1","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-020-07063-1","article-title":"Neutrophil\u2010Lymphocyte Ratio Associated With Poor Prognosis in Oral Cancer: A Retrospective Study","volume":"20","author":"Hasegawa T.","year":"2020","journal-title":"BMC Cancer"},{"issue":"19","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"4002","DOI":"10.7150\/jca.21141","article-title":"Prognostic Effect of Albumin\u2010Globulin Ratio in Patients With Solid Tumors: A Systematic Review and Meta\u2010Analysis","volume":"8","author":"He J.","year":"2017","journal-title":"Journal of Cancer"},{"issue":"1","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-024-05026-7","article-title":"Prognostic Value of Platelet\u2010To\u2010Lymphocyte Ratio in Patients With Oral Squamous Cell Carcinoma: A Systematic Review and Meta\u2010Analysis","volume":"24","author":"Huang L.","year":"2024","journal-title":"BMC Oral Health"},{"issue":"4","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.joms.2021.12.011","article-title":"Systemic Inflammatory Markers as Predictors of Postoperative Complications and Survival in Patients With Advanced Head and Neck Squamous Cell Carcinoma Undergoing Free\u2010Flap Reconstruction","volume":"80","author":"Ko\u0161ec A.","year":"2022","journal-title":"Journal of Oral and Maxillofacial Surgery"},{"issue":"2","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1158\/2326-6066.CIR-15-0313","article-title":"The Complex Role of Neutrophils in Tumor Angiogenesis and Metastasis","volume":"4","author":"Liang W.","year":"2016","journal-title":"Cancer Immunology Research"},{"issue":"5","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","DOI":"10.1002\/mco2.350","article-title":"The Role of Platelets in the Regulation of Tumor Growth and Metastasis: The Mechanisms and Targeted Therapy","volume":"4","author":"Liao K.","year":"2023","journal-title":"MedComm (2020)"},{"key":"e_1_2_12_19_1","volume-title":"WHO Classification of Head and Neck Tumours","author":"Lingen M. W.","year":"2024"},{"issue":"5","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1002\/hed.25075","article-title":"Neutrophil\u2010To\u2010Lymphocyte Ratio in Head and Neck Cancer Prognosis: A Systematic Review and Meta\u2010Analysis","volume":"40","author":"Mascarella M. A.","year":"2018","journal-title":"Head & Neck"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-016-2079-6","article-title":"Pre\u2010Treatment Neutrophil to Lymphocyte Ratio Predicts the Chemoradiotherapy Outcome and Survival in Patients With Oral Squamous Cell Carcinoma: A Retrospective Study","volume":"16","author":"Nakashima H.","year":"2016","journal-title":"BMC Cancer"},{"issue":"3","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s10147-014-0689-z","article-title":"Current Status of Oral Cancer Treatment Strategies: Surgical Treatments for Oral Squamous Cell Carcinoma","volume":"19","author":"Omura K.","year":"2014","journal-title":"International Journal of Clinical Oncology"},{"issue":"8","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1016\/j.joms.2016.12.023","article-title":"Low Pretreatment Lymphocyte\u2010Monocyte Ratio and High Platelet\u2010Lymphocyte Ratio Indicate Poor Cancer Outcome in Early Tongue Cancer","volume":"75","author":"Ong H. S.","year":"2017","journal-title":"Journal of Oral and Maxillofacial Surgery"},{"issue":"6","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","DOI":"10.1002\/eji.202451767","article-title":"Pro\u2010 and Anti\u2010Inflammatory Role of Complement in Cancer","volume":"55","author":"Pal P.","year":"2025","journal-title":"European Journal of Immunology"},{"issue":"4","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.oraloncology.2008.05.018","article-title":"Lifestyle Risk Factors for Oral Cancer","volume":"45","author":"Petti S.","year":"2009","journal-title":"Oral Oncology"},{"issue":"1","key":"e_1_2_12_26_1","doi-asserted-by":"crossref","DOI":"10.1007\/s00423-023-02786-8","article-title":"Prognostic Role of Platelet\u2010Lymphocyte Ratio, Neutrophil\u2010Lymphocyte, and Lymphocyte\u2010Monocyte Ratio in Operated Rectal Cancer Patients: Systematic Review and Meta\u2010Analysis","volume":"408","author":"Portale G.","year":"2023","journal-title":"Langenbeck's Archives of Surgery"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.oraloncology.2017.07.003","article-title":"Prognostic Biomarkers in Oral Squamous Cell Carcinoma: A Systematic Review","volume":"72","author":"Rivera C.","year":"2017","journal-title":"Oral Oncology"},{"issue":"12","key":"e_1_2_12_28_1","doi-asserted-by":"crossref","first-page":"3499","DOI":"10.1158\/0008-5472.CAN-13-0371","article-title":"Immune Infiltrates Are Prognostic Factors in Localized Gastrointestinal Stromal Tumors","volume":"73","author":"Rusakiewicz S.","year":"2013","journal-title":"Cancer Research"},{"issue":"3","key":"e_1_2_12_29_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/aam.aam_56_18","article-title":"Inflammation and Cancer","volume":"18","author":"Singh N.","year":"2019","journal-title":"Annals of African Medicine"},{"issue":"4","key":"e_1_2_12_30_1","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1177\/01945998221098011","article-title":"Changing Epidemiology of Oral Cavity Cancer in the United States","volume":"168","author":"Stepan K. O.","year":"2023","journal-title":"Otolaryngology and Head and Neck Surgery"},{"issue":"3","key":"e_1_2_12_31_1","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1002\/hed.24986","article-title":"Prognostic Role of Neutrophil\u2010To\u2010Lymphocyte Ratio in Head and Neck Cancer: A Meta\u2010Analysis","volume":"40","author":"Takenaka Y.","year":"2018","journal-title":"Head & Neck"},{"issue":"7","key":"e_1_2_12_32_1","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1007\/s00405-018-4972-x","article-title":"The Lymphocyte\u2010Monocyte Ratio as a Prognostic Indicator in Head and Neck Cancer: A Systematic Review and Meta\u2010Analysis","volume":"275","author":"Tham T.","year":"2018","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"7","key":"e_1_2_12_33_1","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1007\/s00405-018-4972-x","article-title":"The Lymphocyte\u2010To\u2010Monocyte Ratio as a Prognostic Indicator in Head and Neck Cancer: A Systematic Review and Meta\u2010Analysis","volume":"275","author":"Tham T.","year":"2018","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"7","key":"e_1_2_12_34_1","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1002\/hed.23400","article-title":"Pretreatment Circulating Monocyte Count Associated With Poor Prognosis in Patients With Oral Cavity Cancer","volume":"36","author":"Tsai Y. D.","year":"2014","journal-title":"Head & Neck"},{"issue":"1","key":"e_1_2_12_35_1","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s00405-020-06145-x","article-title":"Retrospective Study on the Potential of Albumin\/Globulin Ratio as a Prognostic Biomarker for Oral Cavity Cancer Patients","volume":"278","author":"Wang Y. T.","year":"2021","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"4","key":"e_1_2_12_36_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0250091","article-title":"Prognostic Value of the Postoperative Neutrophil\u2010Lymphocyte Ratio in Solid Tumors: A Meta\u2010Analysis","volume":"16","author":"Wu M.","year":"2021","journal-title":"PLoS One"},{"issue":"6","key":"e_1_2_12_37_1","doi-asserted-by":"crossref","DOI":"10.1042\/BSR20181550","article-title":"Prognostic and Clinicopathological Significance of Neutrophil\u2010Lymphocyte Ratio in Patients With Oral Cancer","volume":"38","author":"Yang Y.","year":"2018","journal-title":"Bioscience Reports"},{"issue":"1","key":"e_1_2_12_38_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-023-11752-y","article-title":"Correlation Between Preoperative Peripheral Blood NLR, PLR, LMR and Prognosis of Patients With Head and Neck Squamous Cell Carcinoma","volume":"23","author":"Zhou J.","year":"2023","journal-title":"BMC Cancer"},{"issue":"3","key":"e_1_2_12_39_1","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/odi.13774","article-title":"A Novel Prognostic Score Based on Systemic Inflammatory Biomarkers for Patients With Oral Squamous Cell Carcinoma","volume":"28","author":"Zhuang Z.","year":"2022","journal-title":"Oral Diseases"}],"container-title":["Oral Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/odi.70515","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/odi.70515","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/odi.70515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:35:12Z","timestamp":1791268512000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/odi.70515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":38,"alternative-id":["10.1111\/odi.70515"],"URL":"https:\/\/doi.org\/10.1111\/odi.70515","archive":["Portico"],"relation":{},"ISSN":["1354-523X","1601-0825"],"issn-type":[{"value":"1354-523X","type":"print"},{"value":"1601-0825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2026-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"odi.70515"}}