The effects of prognostic nutritional index, systemic immune inflammation index and HALP score on fistula formation, recurrence and mortality in laryngeal cancer patients

Abstract Purpose The aim of this study was to investigate the effects of prognostic nutritional index (PNI), systemic immune inflammation index (SII) and hemoglobin, albumin, lymphocyte, platelet (HALP) score on fistula formation, recurrence and mortality in patients with laryngeal cancer. Method The study included 77 patients who underwent total laryngectomy operation between 2018 and 2021. 66 (85.7%) patients underwent primary and 11 (14.3%) patients underwent salvage total laryngectomy. PNI, SII and HALP scores and cutt-off values of all patients were determined and the relationships between pharyngocutaneous fistula (PCF) formation, recurrence and mortality were statistically analysed. The patients with a score less than the cut-off value were divided into two groups as Group 1, and the patients with a score equal to or greater than the cut-off value were divided into two groups as Group 2. Results The effect of PNI, SII and HALP on the development of FKF was not significant ( P = 0.110, P = 0.135, P = 0.358). The effect of high SII and low HALP score on the development of recurrence was statistically significant ( P = 0.001, P = 0.012). Low PNI increased the development of recurrence, but this increase was not statistically significant ( P = 0.075). Overall survival rate was 68.8%. The effect of low PNI and HALP on survival was statistically significant ( P = 0.011, P = 0.021). The effect of high SII on survival was not significant ( P = 0.533). Conclusion Low PNI index and HALP score and high SII index are cost-effective simple prognostic biomarkers that are significant in the development of FCF, as well as in the evaluation of recurrence and overall survival in the long-term follow-up of these patients.