A disease-specific immunonutritional model for prognostic stratification in oral cavity squamous cell carcinoma
- 1Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital
- 2College of Medicine, Chang Gung University
- 3Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education
Abstract
Background The Naples Prognostic Score (NPS) has demonstrated prognostic value across malignancies; however, its applicability to oral cavity squamous cell carcinoma (OCSCC) remains uncertain. We aimed to develop a disease-specific immunonutritional model for prognostic stratification in surgically treated OCSCC, informed by the NPS framework. Methods We retrospectively analyzed 351 patients undergoing curative surgery for OCSCC (2009–2018). Survival-optimized cutoffs for albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio were determined using X-tile and integrated into a composite score (OCSCC-specific Naples Prognostic Score, OCNPS) to classify patients into three risk groups (Groups 0–2). Associations with overall survival (OS) and disease-free survival (DFS) were evaluated using Cox proportional hazards models. Results The proposed model stratified patients into distinct risk groups and was associated with adverse pathological features. Five-year OS rates were 81.2%, 63.4%, and 10.4% across Groups 0–2, whereas the original NPS did not discriminate between low- and intermediate-risk patients. In multivariable analyses, higher OCNPS categories independently predicted worse OS and DFS (Group 1: HR 1.63 and 1.42; Group 2: HR 6.46 and 6.66). A nomogram incorporating OCNPS improved prognostic discrimination compared with TNM staging (C-index 0.769 vs. 0.652) with good calibration. Conclusions The OCNPS enables preoperative identification of patients with OCSCC at higher risk of adverse postoperative outcomes and provides clinically applicable prognostic information beyond conventional staging, supporting its potential role in OCSCC management.
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BibTeX
@article{su2026diseasespecific,
title = {{A disease-specific immunonutritional model for prognostic stratification in oral cavity squamous cell carcinoma}},
author = {Yao-Sheng Su and Jhih-Hao Shen and Ku-Hao Fang and Ming-Hsien Tsai and Adarsh Kudva and Yi-Chan Lee and Ethan I. Huang and Ming-Shao Tsai and Geng-He Chang and Cheng-Ming Hsu and Yao-Te Tsai},
journal = {BMC Cancer},
year = {2026},
month = jul,
doi = {10.1186/s12885-026-16633-8},
url = {https://doi.org/10.1186/s12885-026-16633-8},
note = {CC BY},
}
RIS
TY - JOUR
TI - A disease-specific immunonutritional model for prognostic stratification in oral cavity squamous cell carcinoma
AU - Yao-Sheng Su
AU - Jhih-Hao Shen
AU - Ku-Hao Fang
AU - Ming-Hsien Tsai
AU - Adarsh Kudva
AU - Yi-Chan Lee
AU - Ethan I. Huang
AU - Ming-Shao Tsai
AU - Geng-He Chang
AU - Cheng-Ming Hsu
AU - Yao-Te Tsai
PY - 2026
DA - 2026/07/01
JO - BMC Cancer
DO - 10.1186/s12885-026-16633-8
UR - https://doi.org/10.1186/s12885-026-16633-8
AB - Background The Naples Prognostic Score (NPS) has demonstrated prognostic value across malignancies; however, its applicability to oral cavity squamous cell carcinoma (OCSCC) remains uncertain. We aimed to develop a disease-specific immunonutritional model for prognostic stratification in surgically treated OCSCC, informed by the NPS framework. Methods We retrospectively analyzed 351 patients undergoing curative surgery for OCSCC (2009–2018). Survival-optimized cutoffs for albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio were determined using X-tile and integrated into a composite score (OCSCC-specific Naples Prognostic Score, OCNPS) to classify patients into three risk groups (Groups 0–2). Associations with overall survival (OS) and disease-free survival (DFS) were evaluated using Cox proportional hazards models. Results The proposed model stratified patients into distinct risk groups and was associated with adverse pathological features. Five-year OS rates were 81.2%, 63.4%, and 10.4% across Groups 0–2, whereas the original NPS did not discriminate between low- and intermediate-risk patients. In multivariable analyses, higher OCNPS categories independently predicted worse OS and DFS (Group 1: HR 1.63 and 1.42; Group 2: HR 6.46 and 6.66). A nomogram incorporating OCNPS improved prognostic discrimination compared with TNM staging (C-index 0.769 vs. 0.652) with good calibration. Conclusions The OCNPS enables preoperative identification of patients with OCSCC at higher risk of adverse postoperative outcomes and provides clinically applicable prognostic information beyond conventional staging, supporting its potential role in OCSCC management.
SN - 1471-2407
ER -