Research Article Role of Pretreatment Hemoglobin-to-Platelet Ratio in Predicting Survival Outcome of Locally Advanced Nasopharyngeal Carcinoma Patients Cosphiadi Irawan , 1 Andhika Rachman , 1 Puji Rahman, 2 and Arif Mansjoer 3 1 Division of Hematology and Medical Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital–Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia 2 Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital–Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia 3 Clinical Epidemiology Unit, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital–Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia Correspondence should be addressed to Cosphiadi Irawan; cosphiadi.irawan@ui.ac.id Received 2 July 2021; Accepted 13 October 2021; Published 30 October 2021 Academic Editor: Samuel Antwi Copyright © 2021 Cosphiadi Irawan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. The three-year survival rate of locally advanced nasopharyngeal carcinoma (NPC) patients in Indonesia is lower than in other Asian countries. Calculation of hemoglobin-to-platelet ratio (HPR) may become a more practical predictor than the ratios using leukocyte cell components. Yet, no study has been conducted to investigate the potential of HPR in predicting survival outcomes in locally advanced nasopharyngeal cancer patients. Objective. To determine the role of pretreatment hemoglobin-to- platelet ratio in predicting the three-year overall survival (OS) of locally advanced NPC. Method. A retrospective cohort study followed up on 289 locally advanced NPC patients who had undergone therapy at the Dr. Cipto Mangunkusumo National General Hospital between January 2012 and October 2016. HPR cut-off was determined using ROC. Subjects were classified into two groups according to the HPR value. Kaplan-Meier curve was utilized to illustrate patients’ three-year survival, and Cox regression test analyzed confounding variables to yield an adjusted hazard ratio (HR). Results. The optimal cut-off for HPR was 0.362 (AUC 0.6228, 95% CI: 0.56-0.69, sensitivity 61.27%, specificity 60.34%). Of the subjects, 48.44% had HPR ≤ 0:362, and they had a higher three-year mortality rate than those with HPR > 0:362 (50% vs. 31.54%). In bivariate analysis, HPR ≤ 0:362 and age ≥ 60 significantly showed a worse three-year OS (p value = 0.003 and 0.075, respectively). In multivariate analysis, we concluded that a pretreatment HPR ≤ 0:362 was an independent negative predictor of three-year OS in locally advanced NPC patients (adjusted HR 1.82; 95% CI: 1.25–2.65). Conclusion. Pretreatment HPR ≤ 0:362 was a negative predictor of three-year OS in locally advanced nasopharyngeal cancer patients. 1. Introduction Nasopharyngeal carcinoma (NPC) is one of the most com- mon cancer in Indonesia, which has the second-highest global incidence. It is the sixth most common cause of cancer-associated death in Indonesia [1–3]. The three-year survival rate of locally advanced NPC patients in Indonesia is lower than that in other Asian countries [4–6]. A previous study found that in our country, many patients are younger than thirty years old and have high latent membrane protein (LMP1) expression [1]. This fact is associated with high Epstein-Barr virus virulence [1]. Therefore, evaluations of Epstein-Barr virus (EBV) markers at diagnosis and surveil- lance are recommended as useful predictors for the outcome; however, their application has been limited in Indonesia due to unavailability of the assay [7–10]. The development of other predictors has also been widely studied, one of which functions through the Hindawi Journal of Cancer Epidemiology Volume 2021, Article ID 1103631, 7 pages https://doi.org/10.1155/2021/1103631