Inflammatory indices predict pharyngocutaneous fistula formation after total laryngectomy

Objective: Inflammatory indices (IIs), such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and prognostic nutritional index (PNI) reflect the prognosis of several types of solid tumors, including laryngeal cancer. To the best of our knowledge, with the exception of NLR, the role of IIs in the prediction of pharyngocutaneous fistula (PCF) has not been investigated, and we aimed to do so in this study. Methods: A total of 155 patients who underwent total laryngectomy (TL) from January 2010 to November 2020 were retrospectively reviewed. Results: The PCF incidence was 31.6%. When the incidence of PCF was compared on the basis of IIs, its association with SII, NLR, PLR, and MLR was statistically significant (p=0.001, 0.002, 0.011, and 0.033, respectively). The cut-off values for SII, NLR, PLR, and MLR were 706, 2.90, 136, and 0.33, respectively. The correlation between PCF and the cut-off values of SII, NLR, and PLR was statistically significant (p=0.015, 0.007, and 0.033, respectively). Conclusion: Our results suggest that pretreatment SII, NLR, and PLR predict PCF after TL. Patients with SII ≥ 706, NLR ≥ 2.90, and PLR ≥ 136 are at risk for the occurrence of PCF.