Multivariate analysis confirmed platelet count as an independent predictor for GR (p = 0.0001) and LR (p = 0.0002), while a high CD4+/CD8+ ratio (p = 0.045) was independently protective against DR.<h4>Conclusion</h4>These findings highlight the prognostic relevance of platelet-related inflammatory markers and circulating T-cell ratios in recurrence risk among HNSCC patients. Here, CD8A is linked to head and neck squamous cell carcinoma.