High fibrinogen-albumin ratio index (FARI) predicts poor survival in head and neck squamous cell carcinoma patients treated with surgical resection

Purpose The aim of the present study was to investigate the predictive value of the fibrinogen/albumin ratio index (FARI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) on the prognosis of patients with operable head and neck squamous cell carcinoma (HNSCC). Methods A cohort of 155 operable HNSCC patients were enrolled. Laboratory and clinical data were extracted from the patients’ electronic medical record. The optimal cut-off values were determined by receiver operating characteristic (ROC) curves analysis. Clinicopathological characteristics of patients were compared via Chi-square test. Survival curves were analyzed by Kaplan–Meier method. The prognostic factors were evaluated by univariate and multivariate analyses via the Cox hazards regression analysis. Results The median follow-up time was 31.7 months. An increased level of NLR was associated with later T stages, later N stages, and more advanced clinical stages(all P < 0.05). On univariate analyses, FARI, NLR, PLR, and N stage were correlated with progression-free survival (PFS) (all P < 0.05) as well as overall survival (OS) (all P < 0.05). And the clinical stage was only relevant to OS ( P = 0.007). Multivariate Cox regression analysis revealed that FARI (HR 3.486, 95% CI 2.086–5.825, P < 0.001; HR 4.474, 95% CI 2.442–8.199, P < 0.001), NLR (HR 3.163, 95% CI 1.810–5.528, P < 0.001; HR 3.690, 95% CI 1.955–6.963, P < 0.001), and N stage (HR 1.718, 95% CI 1.058–2.789, P = 0.029; HR 1.777, 95% CI 1.024–3.084, P = 0.041) were independent prognostic factors for PFS and OS. Conclusion Our findings indicate that FARI and NLR are effective and convenient markers for predicting prognosis in operable HNSCC patients.