Pre-Treatment and Post-Treatment Neutrophil-to- Lymphocyte Ratio Predict Pathological Tumor Response and Survival in Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy

Patients with elevated post-CRT NLR had significantly worse 5-year overall survival (OS), disease-free survival (DFS) and local regional recurrence-free survival (LRRFS) rates compared to low post-CRT NLR in multivariate analysis (46.6% vs. 74.4%, p=0.020; 35.3% vs. 71.9%, p=0.018; 40.8% vs. 78.1%, p=0.006).

📌 3 Key Takeaways

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Objective & Hypothesis:OBJECTIVE The aim of this study is to investigate the relationship between baseline and post-treatment neutrophil- to-lymphocyte ratio (NLR) levels and response to neoadjuvant chemoradiotherapy (CRT) in terms of good pathological response and survival.

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Key Findings & Data:RESULTS The receiver operating characteristic analysis revealed appropriate cut-off values of 2.87 for pre-CRT NLR associated with good pathological response and 8.68 for post-CRT NLR predicting survival.

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Conclusion & Impact:Patients with elevated post-CRT NLR had significantly worse 5-year overall survival (OS), disease-free survival (DFS) and local regional recurrence-free survival (LRRFS) rates compared to low post-CRT NLR in multivariate analysis (46.6% vs. 74.4%, p=0.020; 35.3% vs. 71.9%, p=0.018; 40.8% vs. 78.1%, p=0.006).

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

OBJECTIVE The aim of this study is to investigate the relationship between baseline and post-treatment neutrophil- to-lymphocyte ratio (NLR) levels and response to neoadjuvant chemoradiotherapy (CRT) in terms of good pathological response and survival. METHODS Fifty-six patients who underwent neoadjuvant CRT and curative surgery for locally advanced rectal cancer (LARC) were analyzed retrospectively. Pre-CRT and post-CRT hematologic parameters were recorded. The link between NLR and clinical outcomes was explored. RESULTS The receiver operating characteristic analysis revealed appropriate cut-off values of 2.87 for pre-CRT NLR associated with good pathological response and 8.68 for post-CRT NLR predicting survival. The low pre-CRT NLR group had better outcomes in terms of good pathological response compared to the high pre-CRT NLR group (OR 4.15, 95% CI 1.23-13.76, p=0.021). However, the analysis failed to show the correlation between NLR and pCR (OR 2.74, 95% CI 0.37-20.15, p=0.320). Patients with elevated post-CRT NLR had significantly worse 5-year overall survival (OS), disease-free survival (DFS) and local regional recurrence-free survival (LRRFS) rates compared to low post-CRT NLR in multivariate analysis (46.6% vs. 74.4%, p=0.020; 35.3% vs. 71.9%, p=0.018; 40.8% vs. 78.1%, p=0.006). CONCLUSION High pre-CRT NLR might be used as a poor pathological tumor response predictor in LARC patients treated with neoadjuvant CRT. In addition, low post-CRT NLR is associated with favorable OS, DFS, and LRRFS. Therefore, easily accessible and cost-effective NLR can be considered as a potential predic- tive marker to identify patients and establish personalized treatment strategies.

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Cite This Article

SOYKUT, E. D., KEMAL, Y., ODABAŞI, E., ŞAHİN, N., YAĞIZ, B. K., YAZICIOĞLU, İ. M., ARSLAN, S. A., GÜNEY, Y. (2022). Pre-Treatment and Post-Treatment Neutrophil-to- Lymphocyte Ratio Predict Pathological Tumor Response and Survival in Rectal Cancer Patients Treated with Neoadjuvant Chemoradiotherapy. Türk Onkoloji Dergisi, Cilt: 37 - Sayı: 2, 139–149. https://ajindex.com/articles/639044

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