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Abstract

Background/purpose: Systemic inflammation and nutritional status are key determinants of cancer progression and survival. The Naples prognostic score (NPS), integrating nutritional and inflammatory biomarkers, has shown prognostic value in cancers, however its significance in oral squamous cell carcinoma (OSCC) remains unclear. This study evaluated the prognostic value of NPS in patients with OSCC undergoing curative surgery. Materials and methods: This retrospective cohort study included 334 patients with OSCC who underwent surgery at a Taiwanese medical center between 2002 and 2015. Preoperative serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio were used to calculate NPS. Patients were categorized into three groups: Group 0 (score = 0), Group 1 (score = 1–2), and Group 2 (score = 3–4). Five-year overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan–Meier methods and log-rank tests. Multivariate Cox proportional hazards regression was performed to identify independent prognostic factors.

Results: The 5-year OS and PFS rates were 60.0% and 47.9%, respectively. Higher NPS values were significantly associated with poorer OS and PFS (log-rank P < 0.0001). In multivariate analysis, NPS remained an independent prognostic factor for OS. Compared with Group 0, hazard ratios were 2.06 for Group 1 and 2.60 for Group 2 (P = 0.038). The prognostic significance of NPS persisted after adjustment for clinicopathological variables, including surgical margin status, depth of invasion, and extranodal extension.

Conclusion: NPS is an independent prognostic indicator in patients with OSCC undergoing surgery. Incorporating NPS into preoperative assessment may improve risk stratification and support treatment planning.

Publication Date

2026

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