Abstract:Abstract: Head and neck squamous cell carcinoma (HNSCC) is a biologically heterogeneous malignancy in which clinical outcomes are shaped by the complex interactions among tumor burden, patterns of regional metastasis, host inflammatory-immune status, and therapeutic strategies. In recent years, peripheral blood inflammatory markers and cervical lymph node-related parameters have attracted increasing attention as accessible, cost-effective, and reproducible tools for risk stratification and prognostic assessment in HNSCC. Lymph node ratio (LNR) and examined lymph node number (ELN) provide complementary information to conventional staging by capturing regional metastatic burden and the adequacy of pathological assessment, whereas neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) serve as surrogate indicators of systemic inflammatory responses and immune homeostasis. Current evidence suggests that these biomarkers are associated with survival outcomes in HNSCC; however, their clinical interpretation is substantially affected by primary tumor subsite, HPV status, therapeutic strategies, timing of assessment, and cutoff definitions, underscoring the absence of a universally applicable standardized evaluation framework. Particularly in the era of immunotherapy, inflammatory markers currently demonstrate greater value for prognostic stratification than for treatment selection, and their potential role as predictive biomarkers for therapeutic response remains to be validated in prospective, high-level clinical studies. Future studies should integrate multicenter prospective cohorts with molecular profiling, immune microenvironmental characterization, and longitudinal monitoring data to develop precise individualized risk assessment models with robust predictive performance and clinical utility.
