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Background There is considerable evidence that platelets contribute to cancer growth and metastatic dissemination. In recent studies, altered mean platelet volume (MPV) has been associated with prognosis in different types of cancer. However, the prognostic role of the MPV in head and neck squamous cell cancer (HNSCC) is currently discussed controversially. The present study was performed to analyze and further elucidate the prognostic significance of the MPV in HNSCC. Methods A total of 319 oropharyngeal squamous cell cancer (OPSCC) patients treated with radiotherapy at a tertiary academic center were enrolled in the present study. Kaplan–Meier method as well as uni- and multivariate Cox proportional hazards were used to evaluate the impact of MPV on cancer-specific survival (CSS), locoregional control (LC) and recurrence-free survival (RFS). Results The median MPV was 10.30 fL (mean 10.26 ± 1.17fL). Univariate analyses showed a significant association of the MPV with CSS (HR 0.85, 95% CI 0.74–0.98, p = 0.025), LC (HR 0.86, 95% CI 0.74–0.99, p = 0.034) and RFS (HR 0.87, 95% CI 0.76–0.996; p = 0.043). In multivariate analysis, the MPV remained an independent prognostic factor for CSS (HR 0.77, 95% CI 0.63–0.93, p = 0.008), LC (HR 0.80, 95% CI 0.65–0.98, p = 0.030), and RFS (HR 0.83, 95% CI 0.685–0.999, p = 0.049). Conclusions Our findings indicate that the MPV is a prognostic marker in OPSCC patients and may contribute to future individual risk assessment.

The purpose of the present study was to evaluate the prognostic significance of the pre- treatment C-reactive protein (CRP) level in a cohort of 503 patients with oral and oropharyngeal cancer treated at a tertiary academic center between 2000 and 2017. Cancer-specific survival (CSS), overall survival (OS) and loco-regional control (LC) were calculated using Kaplan-Meier analysis. To evaluate the prognostic value of the CRP level for the clinical endpoints, univariate and multivariate Cox regression models were applied. The median follow-up period was 61 months. Patients were divided into elevated CRP (&ge, 5 mg/L) and normal CRP groups, according to pre-treatment plasma levels. An increased CRP level was significantly associated with shorter CSS (p &lt, 0.001, log-rank test), as well as with shorter OS (p &lt, 0.001, log-rank test) and loco-regional control (p = 0.001, log-rank test). In addition, multivariate analysis identified CRP as an independent predictor for CSS (hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.08&ndash, 2.35, p = 0.020) as well as for OS (HR 1.62, 95%CI 1.17&ndash, 2.24, p = 0.004) and LC (HR 1.50, 95%CI 1.06&ndash, 2.14, p = 0.023). In subgroup analysis, Kaplan Meier curves revealed that an elevated pre-treatment CRP level was a consistent prognostic factor for poor CSS (p = 0.003, log-rank test), OS (p = 0.001, log-rank test), and LC (p = 0.028, log-rank test) in patients treated with definitive (chemo-) radiotherapy, whereas a significant association in patients undergoing surgery and postoperative radiotherapy was not detected. The pre-treatment CRP level seems to represent a prognostic factor for CSS, OS, and LC in patients with oral and oropharyngeal cancer, particularly in those treated with definitive (chemo-) radiotherapy. Additional large-scale prospective studies are warranted to confirm and extend our findings.

BACKGROUND: Lung cancer remains a leading cause of cancer death. For limited disease nonsmall cell lung cancer (NSCLC), surgical resection is state-of-the-art. Functional- or anatomic inoperability and poor performance status require alternative treatment. METHODS: A study initiated in 1987 investigates intraoperative radiation therapy (IORT) combined with external beam irradiation (EBI) as therapeutic alternative for patients with NSCLC whose performance status allows thoracotomy but not lobectomy. All of so far 52 patients – 14 females (26.9%), 38 males (73.07%) aged 49 to 80 years (median: 65 years) – underwent IORT carried out by postero-lateral thoracotomy. EBI happened in 50 patients 4 weeks after IORT. RESULTS: With 50 patients completing EBI the actuarial overall survival was 71.2%, 55.8%, 34.6%, the diseases specific one was 76%, 63.2%, 49.5% at 12, 24 and 36 months, respectively. CONCLUSIONS: Combined IORT and EBI represent an efficient, feasible, and well-tolerated treatment option for NSCLC patients ineligible for lung resection.